ADRENOCORTICAL CANCER: THE DIFFICULTIES OF DIAGNOSIS AND TREATMENT

Abstract

Adrenocortical cancer is a rare and highly aggressive tumor of the adrenal cortex, which is most often diagnosed in advanced stages, resulting in an unfavorable prognosis for most patients.
This article describes a clinical case of hormone-active adrenocortical cancer of the left adrenal gland in a young woman. The patient had symptoms of hypercorticism (dysplastic obesity, bluish-purple striae, hypertension, diabetes mellitus, amenorrhea, hirsutism). An examination at the outpatient stage revealed an increased level of cortisol in daily urine >100 micrograms / day, an ultrasound of the abdominal cavity organs in the projection of the left kidney with the size of 200*129*195 mm, with fuzzy uneven contours. Ultrasound signs of multiple focal liver formations (probably mts). An additional examination by an endocrinologist is recommended, but the patient did not seek advice.
After 5 months, due to the increased symptoms of hypercorticism and the appearance of abdominal and lumbar pain, the patient urgently went to the hospital on duty. Where the additional examination was carried out: a laboratory study aimed at detecting hormonal disorders and topical diagnostics (MSCT of the thoracic and abdominal organs – in the projection of the left adrenal gland, and the upper pole of the left kidney, the formation is determined by the size of up to 22*12*10 see, secondary damage to the liver, lungs, and lymph nodes).
The patient was consulted by an oncologist at an oncological dispensary. Surgical treatment is not indicated for the patient, palliative treatment is recommended.
6 months after the onset of symptoms, the patient develops hepatic-renal insufficiency, cerebral edema and death of the patient occurs.