Abstract

GONZALEZ CALERO, Teresa Margarita; CONESA GONZALEZ, Ana Ibis; HERNANDEZ MARTINEZ, Julio César  and  LEAL CURI, Lisett. Rapidly evolving adrenal carcinoma. Rev Cubana Endocrinol [online]. 2013, vol.24, n.3, pp. 270-278. ISSN 1561-2953.

Introduction: primary suprarrenal carcinoma is a highly aggressive rare carcinoma of rapid growth, with greater incidence in 40-60 years age group. The functioning carcinomas represent up to 79 % of cortical tumors that are more frequent in females, and 50 % of them clinically manifests as Cushing syndrome. The extension of the tumor to neighboring structures is common and worsens the prognosis. Mean survival rate is 2 years from the time of diagnosis, particularly when there are liver and lung metastases. Objective: to describe the clinical characteristics, the diagnostic and therapeutic procedures in a female patient with rapidly evolving adrenal carcinoma. Case presentation: a patient LRS, female, Caucasian, 49 years-old, with a history of blood hypertension and type 2 diabetes mellitus, who went to the hospital because of lack of metabolic control and blood hypertension. On physical examination, there were observed some signs suggestive of hypercortisolism, symptomatology that became notably acute two months later. Basal, dynamic, imaging and anatomopathological studies were made to corroborate the presumptive diagnosis. Left adrenalectomy with regional adenectomy was performed, and the diagnosis of left suprarenal carcinoma was confirmed through pathological anatomy. Few months later, the patient died from osseous metastasis in her spinal cord. Conclusions: early recognition of symptoms and signs of adrenal hyperfunction is very important for diagnosis and timely treatment of adrenal carcinoma.

Keywords : adrenal carcinoma; Cushing syndrome; neoplasia; endogenous hypercortisolism.

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