Skip to main content Skip to main navigation menu Skip to site footer

Rhabdoid adrenocortical carcinoma with brain metastasis: a case report



Abstract

Introduction: Adrenocortical carcinoma (ACC) is a rare disease with the incidence about 0,02-0,2% from all case of malignancies. The number of malignancies cases reported annually being about 0,7-2 cases per million people. ACC can be functional or nonfunctional tumors, being diagnosed incidentally because of loco-regional symptoms or distant metastases. The overall 5-year survival rate after diagnosis was 15% to 47% and there are no significant differences in survival based on patient age, gender or tumor functional status.

Case Report: A 47 years old male came into emergency room with nauseous, vomiting, headache and weakness for 4 weeks. From the physical examination, there were slight hypertension and tenderness on left hypochondric region. Abdominal ultrasound showed a solid mass with central necrotic on upper left abdominal cavity. Then, contrast abdominal CT revealed a well defined heterogeneous solid mass, contrast enhancement with necrotic area that attached on the upper pole of left kidney suspicious on left adrenal organ. He was performed left radical adrenalectomy as initial treatment to determine the histopathology result and tumor staging. After surgery complains of his headache remained, thus head CT was performed and it concluded an intracranial metastatic process at right parietal region, left temporal brain parenchymal and cerebellum which pressing ventricle IV. Steroid and neurotrophic treatment were given by neurologic division. This patient was also consulted to neurology, hemato-oncology, neurosurgery and radiotherapy for further treatment.

Conclusion: ACC is a progressive disease with a poor prognosis because of its initial presentation with advance disease (tumor burden or distant metastases), high incidence of local recurrence, and systemic therapy still controversial. The patient has to do a complete physical examination, imaging and laboratory work-up. Multimodality treatment with a multidisciplinary approach is needed to manage the patient for optimal outcome.

Keywords: Adrenocortical carcinoma adrenal tumor adrenalectomy pheochromocytoma.

References

  1. Andre P, Justine B. Adrenal tumors in adults. Surgical Pathology. 2015;8:725–749.
  2. Annikka W, Alexandria P, Saul S, Cesar M. Primary rhabdoid adrenocortical carcinoma: a clinicopathological and immunohistochemical study of three cases. Histopathology 2013;62:771–777.
  3. Aparna C, Renuka I.V, Saila B, Annapurna P. Adrenocortical carcinoma: Report of two cases. Indian Journal of Endocrinology and Metabolism. 2011;15(3):18-24.
  4. Attila K, Ioan J, et al. First Case Report of a Sporadic Adrenocortical Carcinoma With Gastric Metastasis and a Synchronous Gastrointestinal Stromal Tumor of the Stomach. Medicine Clinical Case Report. 2015, vol 94, p.1.
  5. Clinton D. Kemp, Taylor R, Aarti M. Pulmonary Resection for Metastatic Adrenocortical Carcinoma: The National Cancer Institute Experience. Ann Thorac Surg. 2011;92:1195–201.
  6. David A, Jennifer R, Kristina B. Evaluation and management of the incidental adrenal mass. BUMC Proceedings. 2003;16:7–12.
  7. Euddum S, Suk Keu Y, Jun Won U et al. Malignant Extrarenal Rhabdoid Tumor in Adults: Three Case Reports Originating from the Ileum, Adrenal Gland and Uterus. J Korean Soc Radiol. 2014;71(1):20-25.
  8. Hermsen, Gelderblom, Kievit et al. Extremely long survival in six patients despite recurrent and metastatic adrenal carcinoma. European Journal of Endocrinology. 2008;158:911–919.
  9. Kou et al. A case of adrenocortical carcinoma accompanying secondary acute adrenal hypofunction postoperation. World Journal of Surgical Oncology.2018;16:43-49.
  10. Linda N, John L. Adrenocortical carcinoma : Diagnosis, evaluation, and treatment. The Journal of Urology. 2003;169:2-4.
  11. Mauricio B, Nishant T, Avi R, et al. Brain Metastasis In Patients with Adrenocortical carcinoma: A Clinical series. J Clin Endocrinol Metab. 2014;3(2):14-19.
  12. Rossella L. Adrenocortical carcinoma (ACC): Diagnosis, prognosis, and treatment. Journal Frontiers in Cell and Developmental Biology. 2015;3:2-6.
  13. Santosh M, Senjuti D, Parul J et al. Histopathological study of adrenocortical carcinoma with special reference to the Weiss system and TNM staging and the role of immunohistochemistry to differentiate it from renal cell carcinoma. Journal of Cancer Research and Therapeutics. 2013;9:436.
  14. Sultan A, Shahad A, Hala M, et al. Adrenocortical Carcinoma in a Young Patient: Report of a Rare Case and Review of the Literature at King Abdulaziz University. Int Arch Urol Complic. 2018;4:48-53.
  15. Wein, Alan J., Louis R Kavoussi, and Meredith F. Campbell. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier Saunders; 2012.

How to Cite

Yudiana, I. W., Prawira, M. M., Pramana, I. B. P., Tirtayasa, P. M. W., Santosa, K. B., Duarsa, G. W. K., & Oka, A. A. G. (2019). Rhabdoid adrenocortical carcinoma with brain metastasis: a case report. Bali Medical Journal, 8(3), 908–914. https://doi.org/10.15562/bmj.v8i3.1606
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
1

Total
1

Share

Search Panel

I Wayan Yudiana
Google Scholar
Pubmed
BMJ Journal

Made Moniaga Prawira
Google Scholar
Pubmed
BMJ Journal

Ida Bagus Putra Pramana
Google Scholar
Pubmed
BMJ Journal

Pande Made Wisnu Tirtayasa
Google Scholar
Pubmed
BMJ Journal

Kadek Budi Santosa
Google Scholar
Pubmed
BMJ Journal

Gede Wirya Kusuma Duarsa
Google Scholar
Pubmed
BMJ Journal

Anak Agung Gede Oka
Google Scholar
Pubmed
BMJ Journal