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Case Reports
. 2019 Jan;36(1):54-58.
doi: 10.12701/yujm.2019.00017. Epub 2018 Dec 20.

Estrogen-secreting adrenocortical carcinoma

You Jeong  1 , Sung Chul Cho  1 , Hee Joon Cho  1 , Ji Soo Song  1 , Joon Seog Kong  2 , Jong Wook Park  3 , Yun Hyi Ku  1
Affiliations
Case Reports

Estrogen-secreting adrenocortical carcinoma

You Jeong et al. Yeungnam Univ J Med. 2019 Jan.

Abstract

Adrenocortical carcinoma is a rare type of endocrine malignancy with an annual incidence of approximately 1-2 cases per million. The majority of these tumors secrete cortisol, and a few secrete aldosterone or androgen. Estrogen-secreting adrenocortical carcinomas are extremely rare, irrespective of the secretion status of other adrenocortical hormones. Here, we report the case of a 53-year-old man with a cortisol and estrogen-secreting adrenocortical carcinoma. The patient presented with gynecomastia and abdominal discomfort. Radiological assessment revealed a tumor measuring 21×15.3×12 cm localized to the retroperitoneum. A hormonal evaluation revealed increased levels of estradiol, dehydroepiandrosterone sulfate, and cortisol. The patient underwent a right adrenalectomy, and the pathological examination revealed an adrenocortical carcinoma with a Weiss' score of 6. After surgery, he was treated with adjuvant radiotherapy. Twenty-one months after treatment, the patient remains alive with no evidence of recurrence.

Keywords: Adrenal gland neoplasm; Adrenocortical carcinoma, Estrogen; Gynecomastia.

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Conflict of interest statement

No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1.
Fig. 1.
Contrast-enhanced abdominal computed tomography reveals a right adrenal mass. Axial (A) and coronal (B) images of a well-defined, heterogeneously enhancing mass measuring 18×11×18 cm between the liver and right kidney.
Fig. 2.
Fig. 2.
Gross appearance of the resected adrenal tumor. The mass was large, solitary, and circumscribed tumor (21×15.3×12 cm). The cut section is yellowish-tan in color, with a variegated appearance. Many areas of necrosis and hemorrhage are visible.
Fig. 3.
Fig. 3.
Microscopic tumor findings. (A) The tumor exhibits a diffuse solid growth pattern with necrosis on the right side (hematoxylin and eosin [H&E] stain, ×40). (B) The tumor cells are round-to-oval in shape with high-nuclear-grade nucleoli. Mitoses are frequently observed (H&E stain, ×400).
Fig. 4.
Fig. 4.
Immunohistochemical staining of the tumor. The Ki-67 index of the tumor cells is 20% (×400).
See this image and copyright information in PMC

References

    1. Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA, et al. Adrenocortical carcinoma: clinical and laboratory observations. Cancer. 2000;88:711–36. - PubMed
    1. Dackiw AP, Lee JE, Gagel RF, Evans DB. Adrenal cortical carcinoma. World J Surg. 2001;25:914–26. - PubMed
    1. Allolio B, Hahner S, Weismann D, Fassnacht M. Management of adrenocortical carcinoma. Clin Endocrinol (Oxf) 2004;60:273–87. - PubMed
    1. Libe R, Fratticci A, Bertherat J. Adrenocortical cancer: pathophysiology and clinical management. Endocr Relat Cancer. 2007;14:13–28. - PubMed
    1. Moreno S, Guillermo M, Decoulx M, Dewailly D, Bresson R, Proye C. Feminizing adreno-cortical carcinomas in male adults. A dire prognosis. Three cases in a series of 801 adrenalectomies and review of the literature. Ann Endocrinol (Paris) 2006;67:32–8. - PubMed

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