We report a case of metastatic adrenocortical carcinoma detected 7 years after adrenalectomy. These nodes were surgically resected, and the histological diagnosis from the resected tissue was metastatic adrenocortical carcinoma. The patient has now survived for more than 9 years following the original adrenalectomy. Evidence suggests that this was a slow-growing tumor, because the primary tumor was sharply demarcated and the metastases were found 7 years after the original operation. We believe that aggressive surgical resection of metastatic lesions could lead to prolonged survival in patients with adrenocortical carcinomas of this type.
Adrenocortical neoplasms are rare in childhood and adolescence.
The prognostic significance of tumor size, weight, and histological grade are still very much unclear. Six presented with virilizing symptoms, two with cushingoid symptoms, one with both, and two others had nonspecific symptoms. Hormonal profile correlated well with clinical presentation in nine patients. Ten patients underwent complete surgical excision, with one intraoperative spillage. Three lesions were less than 5 cm in maximal width, six were between 5 and 10 cm, and two were greater than 10 cm.