Abdulgader Leenah, Esmail Abdullah, Al-Najjar Ebtesam, Khasawneh Bayan, Alharbi Ghazi, Al Awwad Saad
Department of Surgery, University of Maryland Medical Center, Baltimore, MD, USA; Department of Surgery, King Fahd Hospital, Jeddah, Saudia Arabia.
Section of Gastrointestinal Oncology, Houston Methodist Neal Cancer Center, Houston Methodist Hospital, Houston, TX, USA.
Chin Clin Oncol. 2025 Aug;14(4):45. doi: 10.21037/cco-25-26.
Adrenocortical carcinoma (ACC) is a rare and highly aggressive malignancy, ranking as the second most aggressive endocrine tumor after anaplastic thyroid cancer. ACC typically presents symptoms caused by the tumor mass and less often with signs of excess hormones. Due to its rarity, the diagnosis and management of ACC pose significant challenges, with limited clinical guidelines, a lack of large-scale randomized studies, and a paucity of treatment experience.
This report highlights the case of a 51-year-old male patient who presented with a giant intra-abdominal mass, which raised suspicion for ACC. He initially reported a history of abdominal discomfort associated with a large palpable abdominal mass. However, by the time of his presentation to our department, he was asymptomatic. After thorough imaging, a large tumor was resected, and histopathological examination confirmed the diagnosis of ACC. The tumor, measuring 31 cm in diameter and weighing 4.7 kg, is one of the largest reported cases of ACC.
This case is significant as it underscores the critical role of early detection and surgical intervention in potentially improving patient outcomes. Additionally, it highlights the need for continued research to better understand the pathophysiology, diagnosis, and therapeutic approaches to this rare and aggressive malignancy, which remains a considerable clinical challenge.
肾上腺皮质癌(ACC)是一种罕见且侵袭性很强的恶性肿瘤,是继间变性甲状腺癌之后第二大侵袭性最强的内分泌肿瘤。ACC通常表现为肿瘤肿块引起的症状,较少出现激素过多的体征。由于其罕见性,ACC的诊断和治疗面临重大挑战,临床指南有限,缺乏大规模随机研究,且治疗经验匮乏。
本报告重点介绍了一名51岁男性患者的病例,该患者出现巨大腹腔肿块,引发了对ACC的怀疑。他最初报告有腹部不适病史,可触及一个较大的腹部肿块。然而,在他到我们科室就诊时,他并无症状。经过全面的影像学检查后,切除了一个大肿瘤,组织病理学检查确诊为ACC。该肿瘤直径31厘米,重4.7千克,是有报道的最大的ACC病例之一。
该病例意义重大,因为它强调了早期检测和手术干预在潜在改善患者预后方面的关键作用。此外,它突出了持续研究的必要性,以便更好地理解这种罕见且侵袭性强的恶性肿瘤的病理生理学、诊断和治疗方法,这仍然是一个重大的临床挑战。