04 April 2021: Articles
Giant Adrenocortical Carcinoma: A Case Report and Review of the Relevant Literature
Unusual or unexpected effect of treatment, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Ioannis Mantzoros A , Stefanos Bitsianis A , Lydia Loutzidou B , Georgios Ntampakis B , Christos Chatzakis C , Panagiotis Christidis B* , Anna Gkiouliava A , Eleni Koraki A , Stamatios Aggelopoulos EDOI: 10.12659/AJCR.928875
Am J Case Rep 2021; 22:e928875
Table 1. Giant ACCs reported in the literature [3–5,7,10–19].
| Author | Age | Sex | Presentation | Laboratory studies | Tumor size (cm) | Site | Histological findings | Immunohistochemical studies |
|---|---|---|---|---|---|---|---|---|
| Alastrue Vidal et al | 45 | F | Virilization | Elevated: T, DHEA-S | 16.2 | R | ACC | N/R |
| Alastrue Vidal et al | 50 | F | Virilization | Elevated: T, DHEA-S | 20.3 | R | ACC | N/R |
| Almarzouq et al | 30 | F | Abdominal pain, weight loss | Normal | 20 | L | ACC | Vimentin(+),Synaptophysin(+) |
| Bacalbasa et al | 65 | M | Caval compression syndrome, abdominal pain | N/R | 35 | R | ACC | Vimentin(+), Synaptophysin(+), Melan-A(+), Calretinin(+), Ki-67(+) (14%) |
| Bagchi et al | 35 | F | Altered menstrual symptoms | Elevated: serum cortisol, norepinephrine, dopamine | 21 | L | ACC | N/R |
| Benassai et al | 53 | M | Palpable mass on the L flank | Normal | 24 | L | ACC | N/R |
| Brown and Bacal | 64 | M | Abdominal distention | Normal | 19 | R | ACC | N/R |
| Chentli et al | 34 | F | Cushing | Elevated: Serum GLC, E2, T, 17OH P, CA125, Decreased: ACTH, K+, Hb | 14.5 | R ovary | ACC | Inhibin-A(+),Melan-A(+), SF1(+) |
| Chung et al | 36 | F | Incidental finding | Elevated: DHEA-S, Urinary Free Cortisol, 17-KS Decreased: ACTH | 12 | L | ACC | Synaptophysin(+),CD56(+), Inhibin-A(+),Melan-A(+) |
| Coli et al | 75 | F | Abdominal pain | N/R | 15 | L | Sarcomatoid ACC | MNF-116(+), Vimentin(+), Desmin(+), Actin(+), H-Caldesmon(+), Myogenin(+), HMB-45(+) |
| Fancellu et al | 41 | M | Feminization | Elevated: E2, Cortisol, ACTH Decreased: T, Gonadotropins | 27 | L | ACC | Melan-A(+), Synaptophysin(+) |
| Fernandez et al | 64 | F | Abdominal pain | N/R | 12 | R | ACC | N/R |
| Fimmano et al | 61 | M | N/R | N/R | 24 | R | ACC | N/R |
| Fulawka et al | 27 | M | Non-specific | N/R | 22 | L | ACC | Vimentin(+), Inhibin(+),Synaptophysin(+),BCL-2(+), Calretinin(+) |
| Ghorayeb et al | 50 | M | Palpable mass on the L flank | Elevated: DHEA | 18 | L | ACC | Ki-67(+) (12%), IGF-2(+), β-Catenin(+) |
| Habibi et al | 38 | F | Abdominal pain, palpable mass | Normal | 22 | L | ACC | Ki-67(+) (15–20%) |
| Hatano et al | 60 | M | Feminization | Elevated: E2, Preg, P, DOC, 17OH-P, DHEA-S Decreased: T, LH, FSH | 13 | R | ACC | Ki-67(+) (18%), SF1(+) |
| Hoang et al | 39 | M | Ascites, abdominal mass | N/R | 14 | R | ACC | Cytokeratin(+), Vimentin(+), Synaptophysin(+) |
| Hoang et al | 53 | F | Abdominal pain | N/R | 17 | L | ACC | Cytokeratin(+), Vimentin(+), Synaptophysin(+) |
| Hoang et al | 58 | M | 1 year History of rapidly enlarging adrenal mass | N/R | 13 | R | ACC | Cytokeratin(+), Vimentin(+), Synaptophysin(+) |
| Hsieh et al | 82 | F | Primary hyperaldo-steronism | Elevated: ALDO, Decreased: Plasma renin activity | 13 | L | Myxoid ACC | Synaptophysin(+), Melan-A(+), Vimentin(+) |
| Kalra et al | 34 | M | Incidental finding | Normal | 16 | L | ACC | Inhibin-A(+), Melan-A(+) |
| Kashiwagi et al | 47 | F | Lower back pain | Decreased: Hb | 13.5 | L | ACC | N/R |
| Khan et al | 40 | M | Incidental finding | Normal | 30 | R | ACC | N/R |
| Kovecsi et al | 71 | M | Weight loss, epigastric pain | Normal | 13 | R | ACC | Vimentin(+), Inhibin(+), Synaptophysin(+), NSE(+), Ki-67(+) (30%) |
| Kunieda et al | 52 | M | Weight loss, palpable mass | Elevated: Cortisol, S, DHEA-S, DHEA, 17-KS Decreased: ACTH | 29 | R | ACC | N/R |
| Lee et al | 61 | M | Right flank pain | VMA | 12 | R | Sarcomatoid ACC | Cytokeratin(+), Vimentin(+), NSE(+) |
| Lee et al | 21 | M | R flank pain, palpable mass | N/R | 21 | R | ACC | N/R |
| Meshikhes et al | 20 | M | R flank pain, palpable mass | Normal | 24 | L | ACC | Vimentin(+), Inhibin(+), Cytokeratin(+) |
| Ohwada et al | 47 | F | Incidental finding | Normal | 18 | R | ACC | N/R |
| Ohwada et al | 68 | M | Incidental finding | Normal | 16 | R | ACC | N/R |
| Ohwada et al | 62 | M | Weight loss, bilateral Lower extremities edema | Normal | 20 | R | ACC | N/R |
| Ohwada et al | 43 | F | Cushing | Elevated: 17-OHCS, 17- KS, DHEA-S | 15 | R | ACC | N/R |
| Onkar and Shilpi | 47 | M | Non-specific | Normal | 22 | L | ACC | N/R |
| Permana et al | 21 | F | Virilization | Elevated: T, DHEA-S, E2, Morning Cortisol Decreased: LH, FSH, | 15.6 | R | ACC | NSE(+), HEP1(+), CD56(+) |
| Reyes et al | 42 | F | Right flank pain | Normal | 12 | R | ACC | N/R |
| Saeger et al | 53 | F | Incidental finding | N/R | 13 | R | Sarcomatoid ACC | β-Catenin(+), Vimentin(+), Synaptophysin(+), Desmin(+), SF1(+), Melan-A(+), Ki-67(+) (60%) |
| Sasaki et al | 45 | M | Epigastric pain, weight loss | Normal | 17 | L | Sarcomatoid ACC | Synaptophysin(+), Melan-A(+), Vimentin(+), Calretinin(+), Desmin(+), Myogenin(+), Myoglobin(+) |
| Souto et al | 54 | F | Cushing | Elevated: DHEA-S, AE, 17OH-P, T, Urinary free cortisol decreased: LH | 21 | L | ACC | Ki-67(+) (20%) |
| Straka et al | 40 | M | PE | NSE | 26 | R | ACC | Ki-67(+) (12%) |
| Sung et al | 48 | F | Palpable mass | N/R | 19 | R | Myxoid ACC | Ki-67(+) (4%) |
| Sung et al | 59 | F | Incidental finding | N/R | 12.5 | L | Myxoid ACC | Ki-67(+) (5%) |
| Sung et al | 48 | F | Non-specific | N/R | 16 | R | Myxoid ACC | Ki-67(+) (18%) |
| Sung et al | 51 | M | Non-specific | N/R | 15 | R | Sarcomatoid ACC | Ki-67(+) (12%) |
| Tseng et al | 56 | M | AKI, PE | Normal | 24 | R | ACC | Melan-A(+) |
| Uruc et al | 48 | F | Abdominal pain | Elevated: T, DHEA-S | 23 | L | ACC | Vimentin(+), Synaptophysin(+), Cytokeratin(+), Ki-67(+) (13%) |
| Veron Esquivel et al | 39 | F | HTN, HypoK, metabolic alkalosis | Elevated: ALDO, renin, cortisol, T, AE | 13 | R | ACC | N/R |
| Wei et al | 53 | F | Palpable mass | Elevated: T, P | 12 | L | ACC | N/R |
| Wilkinson et al | 64 | F | Abdominal pain | Normal | 12 | L | ACC | N/R |
| Wolf et al | 46 | M | Feminization, varicocele L | Elevated: P2, E, 17-OHCS, 17-KS | 17 | L | ACC | N/R |
| Yavascaoglu et al | 51 | M | L flank pain, weight loss, bilateral leg edema | Normal | 18 | L | ACC | N/R |
| Yeh et al | 53 | F | Virilization | Elevated: T, DHEA-S, AE | 12 | R | ACC | N/R |
| ACC – adrenocortical carcinoma; VMA – vanilmandelic acid; NSE – neuron specific enolase; N/R – not reported; ALDO – aldosterone; AE – androstenedione; T – testosterone; E – estrogens; P2 – pregnadiol; 17-OHCS – 17-hydroxycorticosteroids; 17-KS – 17-Ketosteroids; AKI – acute kidney injury; PE – pulmonary edema; SF1 – steroidogenic factor 1; DHEA-S – dehydroepiandrostenedione-sulfate; IGF-2 – insulin-like growth factor 2; GLC – glucose; P – progesterone; ACTH – adrenocorticotropic hormone; Hb – hemoglobin; Preg – pregnenolone; DOC – deoxycorticosterone; 17OH-P – 17-hydroxyprogesterone; LH – luteinizing hormone; FSH – follicle stimulating hormone, S – 11-Deoxycortisol. | ||||||||