Giant nonfunctioning adrenal tumors: two case reports and review of the literature
Abstract Background There are an estimated 1–2 cases per million per year of adrenocortical carcinoma in the USA. It represents a rare and aggressive malignancy; it is the second most aggressive endocrine malignant disease after anaplastic thyroid carcinoma. Non-secretory adrenal masses are diagnose...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s13256-018-1876-8 |
| _version_ | 1819123732727201792 |
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| author | George Chatzoulis Ioannis Passos Dimitra-Rafailia Bakaloudi Dimitrios Giannakidis Alexandros Koumpoulas Konstantinos Ioannidis Ioannis Tsifountoudis Dimitrios Pappas Panagiotis Spyridopoulos |
| author_facet | George Chatzoulis Ioannis Passos Dimitra-Rafailia Bakaloudi Dimitrios Giannakidis Alexandros Koumpoulas Konstantinos Ioannidis Ioannis Tsifountoudis Dimitrios Pappas Panagiotis Spyridopoulos |
| author_sort | George Chatzoulis |
| collection | DOAJ |
| description | Abstract Background There are an estimated 1–2 cases per million per year of adrenocortical carcinoma in the USA. It represents a rare and aggressive malignancy; it is the second most aggressive endocrine malignant disease after anaplastic thyroid carcinoma. Non-secretory adrenal masses are diagnosed late due to a mass effect or metastatic disease or found incidentally (adrenal incidentalomas). Case presentation The first case report describes a 39-year-old Greek woman who presented to our department with complaints of repeated symptoms of flatulence and epigastric discomfort over a few months. The second case report is about a 67-year-old Greek woman who presented to our department after being evaluated for fatigue, mass effect, and epigastric discomfort. Both of them were diagnosed as having a nonfunctioning adrenocortical carcinoma and underwent open adrenalectomy. Conclusions Approximately 60% of patients with adrenocortical carcinoma present with symptoms and signs of hormonal secretion. Our cases’ adrenocortical carcinomas were not functional. Hormone secretion is not a discriminating feature between benign and malignant adrenocortical masses. The silent clinical nature of nonfunctioning adrenocortical carcinoma results in late diagnosis, while the majority of patients present with locally advanced and/or metastatic disease. Adrenocortical carcinoma is a rare endocrine tumor with a poor prognosis that can be diagnostically challenging and demands high clinical suspicion. The work-up for adrenal masses must include determination of whether the mass is functioning or nonfunctioning and whether it is benign or malignant. |
| first_indexed | 2024-12-22T07:13:02Z |
| format | Article |
| id | doaj.art-8640fd0c4f624c5aad304c37d4b5885e |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-22T07:13:02Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-8640fd0c4f624c5aad304c37d4b5885e2022-12-21T18:34:28ZengBMCJournal of Medical Case Reports1752-19472018-11-011211610.1186/s13256-018-1876-8Giant nonfunctioning adrenal tumors: two case reports and review of the literatureGeorge Chatzoulis0Ioannis Passos1Dimitra-Rafailia Bakaloudi2Dimitrios Giannakidis3Alexandros Koumpoulas4Konstantinos Ioannidis5Ioannis Tsifountoudis6Dimitrios Pappas7Panagiotis Spyridopoulos8Department of Surgery, 424 General Military Hospital of ThessalonikiDepartment of Surgery, 424 General Military Hospital of ThessalonikiDepartment of Surgery, 424 General Military Hospital of ThessalonikiDepartment of Surgery, 424 General Military Hospital of ThessalonikiDepartment of Surgery, 424 General Military Hospital of ThessalonikiDepartment of Surgery, 424 General Military Hospital of ThessalonikiDepartment of Surgery, 424 General Military Hospital of ThessalonikiDepartment of Surgery, 424 General Military Hospital of ThessalonikiDepartment of Surgery, 424 General Military Hospital of ThessalonikiAbstract Background There are an estimated 1–2 cases per million per year of adrenocortical carcinoma in the USA. It represents a rare and aggressive malignancy; it is the second most aggressive endocrine malignant disease after anaplastic thyroid carcinoma. Non-secretory adrenal masses are diagnosed late due to a mass effect or metastatic disease or found incidentally (adrenal incidentalomas). Case presentation The first case report describes a 39-year-old Greek woman who presented to our department with complaints of repeated symptoms of flatulence and epigastric discomfort over a few months. The second case report is about a 67-year-old Greek woman who presented to our department after being evaluated for fatigue, mass effect, and epigastric discomfort. Both of them were diagnosed as having a nonfunctioning adrenocortical carcinoma and underwent open adrenalectomy. Conclusions Approximately 60% of patients with adrenocortical carcinoma present with symptoms and signs of hormonal secretion. Our cases’ adrenocortical carcinomas were not functional. Hormone secretion is not a discriminating feature between benign and malignant adrenocortical masses. The silent clinical nature of nonfunctioning adrenocortical carcinoma results in late diagnosis, while the majority of patients present with locally advanced and/or metastatic disease. Adrenocortical carcinoma is a rare endocrine tumor with a poor prognosis that can be diagnostically challenging and demands high clinical suspicion. The work-up for adrenal masses must include determination of whether the mass is functioning or nonfunctioning and whether it is benign or malignant.http://link.springer.com/article/10.1186/s13256-018-1876-8NonfunctioningAdrenal tumorsAdrenocortical carcinoma (ACC)AdrenalectomyCase reportHormone secretion |
| spellingShingle | George Chatzoulis Ioannis Passos Dimitra-Rafailia Bakaloudi Dimitrios Giannakidis Alexandros Koumpoulas Konstantinos Ioannidis Ioannis Tsifountoudis Dimitrios Pappas Panagiotis Spyridopoulos Giant nonfunctioning adrenal tumors: two case reports and review of the literature Journal of Medical Case Reports Nonfunctioning Adrenal tumors Adrenocortical carcinoma (ACC) Adrenalectomy Case report Hormone secretion |
| title | Giant nonfunctioning adrenal tumors: two case reports and review of the literature |
| title_full | Giant nonfunctioning adrenal tumors: two case reports and review of the literature |
| title_fullStr | Giant nonfunctioning adrenal tumors: two case reports and review of the literature |
| title_full_unstemmed | Giant nonfunctioning adrenal tumors: two case reports and review of the literature |
| title_short | Giant nonfunctioning adrenal tumors: two case reports and review of the literature |
| title_sort | giant nonfunctioning adrenal tumors two case reports and review of the literature |
| topic | Nonfunctioning Adrenal tumors Adrenocortical carcinoma (ACC) Adrenalectomy Case report Hormone secretion |
| url | http://link.springer.com/article/10.1186/s13256-018-1876-8 |
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