Adrenocortical Carcinoma: Case Series Reports and Literature Review

Abstract

Introduction: Adrenocortical carcinoma (ACC) is a rare endocrine malignancy that arises from the adrenal cortex. ACC is a significantly aggressive tumor with an elevated rate of recurrence. Objectives: the core objectives of our study are to summarize our current practice regarding the management of ACC, to assert the challenges in the diagnosis and management of cases of ACC and to illustrate the clinical outcomes post-surgery. Design: Retrospective analysis of five cases presented with features of ACC and had adrenalectomy during the period between 2014 and 2020. Methods: retrospective review of all patients’ data including age, clinical presentation, radiological findings, hormonal profile, operative management, adjuvant treatment, complications, follow up and survival. Results: The average age was 53.8 ± 8.41years of age. Females were more affected than males. Three cases presented with functioning ACC, while two cases had non-functioning ACC. The average tumor size was 12 cm. All the 5 tumors weighted more than 100g.  Four cases had metastasis; two cases presented with metastatic disease and two patients developed metastasis on follow-up post-operatively. Conclusion: ACC is an extremely aggressive malignant tumor with poor outcomes. Early diagnosis, localized disease and clear surgical margins provide the primary treatment for stages I to Ⅲ.