Endocrinol Metab > Volume 27(1); 2012 > Article
Endocrinology and Metabolism 2012;27(1):93-97.
DOI: https://doi.org/10.3803/EnM.2012.27.1.93    Published online March 1, 2012.
A Case of an Adrenocortical Carcinoma with Pulmonary Embolism as the Initial Manifestation.
Hyo Jin Lee, Ji Young Kwak, Young Jip Kim, Tae Ho Kim, Jan Dee Lee, Hyun Woo Lee, Hae Jin Kim, Dae Jung Kim, Yoon Sok Chung, Kwan Woo Lee, Seung Jin Han
1Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea. hsj@ajou.ac.kr
2Department of Endocrinology and Metabolism, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea.
3Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
4Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea.
Abstract
The annual incidence of a first episode of deep vein thrombosis or pulmonary embolism (PE) in the general population is 120 per 100,000. Cancer is associated with an approximately 4- to 7-fold higher risk of thrombosis. Adrenocortical carcinoma (ACC) is a rare type of malignancy, accounting for 0.02% of all cancers reported annually. Approximately 40% of ACCs are nonsecretory. Most patients with nonsecreting tumors have clinical manifestations related to tumor growth (e.g., abdominal or flank pain). Often the adrenal mass is detected by chance via radiographic imaging. As a result, most ACC patients are diagnosed at an advanced stage and have a poor prognosis. Herein, we report a case of a 54-year-old woman who was admitted to our emergency department complaining of dyspnea. She was diagnosed with ACC accompanied by thrombi in the pulmonary artery and inferior vena cava. We performed a left adrenalectomy and administered adjuvant radiotherapy. The patient is currently receiving warfarin and adjuvant mitotane therapy. She was incidentally diagnosed with ACC, with PE as the initial manifestation.
Key Words: Adrenal mass, Adrenocortical carcinoma, Pulmonary thromboembolism


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