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Nie L, Wang S, Feng Z, Sun Y, Wang Z, Dang Q, Gao A, Lv Y. Nonfunctional ectopic adrenocortical carcinoma in the lung: A case report and literature review. Front Oncol 2023; 13:1100207. [PMID: 36874125 PMCID: PMC9978695 DOI: 10.3389/fonc.2023.1100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Background Ectopic adrenocortical tissues and neoplasms are rare and usually found in the genitourinary system and abdominal cavity. The thorax is an extremely rare ectopic site. Here, we report the first case of nonfunctional ectopic adrenocortical carcinoma (ACC) in the lung. Case presentation A 71-year-old Chinese man presented with vague left-sided chest pain and irritable cough for 1 month. Thoracic computed tomography revealed a heterogeneously enhancing 5.3 × 5.8 × 6.0-cm solitary mass in the left lung. Radiological findings suggested a benign tumor. The tumor was surgically excised upon detection. Histopathological examination using hematoxylin and eosin staining showed that the cytoplasm of the tumor cells was rich and eosinophilic. Immunohistochemical profiles (inhibin-a+, melan-A+, Syn+) indicated that the tumor had an adrenocortical origin. The patient showed no symptoms of hormonal hypersecretion. The final pathological diagnosis was non-functional ectopic ACC. The patient was disease-free for 22 months and is still under follow-up. Conclusions Nonfunctional ectopic ACC in the lung is an extremely rare neoplasm that can be easily misdiagnosed as primary lung cancer or lung metastasis, both preoperatively and on postoperative pathological examination. This report may provide clues to clinicians and pathologists regarding the diagnosis and treatment of nonfunctional ectopic ACC.
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Affiliation(s)
- Limin Nie
- Phase I Clinical Research Center, Shandong University Cancer Center, Jinan, Shandong, China.,Department of Oncology, Caoxian People's Hospital, Heze, Shandong, China
| | - Shuyun Wang
- Phase I Clinical Research Center, Shandong University Cancer Center, Jinan, Shandong, China
| | - Zongfeng Feng
- Department of General Surgery, Caoxian People's Hospital, Heze, Shandong, China
| | - Yuping Sun
- Phase I Clinical Research Center, Shandong University Cancer Center, Jinan, Shandong, China
| | - Zhen Wang
- Department of Pathology, Caoxian People's Hospital, Heze, Shandong, China
| | - Qi Dang
- Phase I Clinical Research Center, Shandong University Cancer Center, Jinan, Shandong, China
| | - Aiqin Gao
- Department of Radiation Oncology, Shandong University Cancer Center, Jinan, Shandong, China
| | - Yajuan Lv
- Department of Oncology, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
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See SZ, Bana SA, Ather N, Haberman A. Adrenocortical carcinoma arising from the colonic mesentery. Proc AMIA Symp 2021; 35:239-240. [DOI: 10.1080/08998280.2021.2010263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Samuel Z. See
- Texas A&M University College of Medicine, Bryan, Texas
| | - Sinan Ali Bana
- Department of Radiology, Baylor University Medical Center, Dallas, Texas
| | - Nuvaira Ather
- Department of Pathology, Baylor University Medical Center, Dallas, Texas
| | - Amy Haberman
- Department of Radiology, Baylor University Medical Center, Dallas, Texas
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Costache MF, Arhirii RE, Mogos SJ, Lupascu-Ursulescu C, Litcanu CI, Ciumanghel AI, Cucu C, Ghiciuc CM, Petris AO, Danila N. Giant androgen-producing adrenocortical carcinoma with atrial flutter: A case report and review of the literature. World J Clin Cases 2021; 9:5575-5587. [PMID: 34307612 PMCID: PMC8281402 DOI: 10.12998/wjcc.v9.i20.5575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/24/2021] [Accepted: 04/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adrenocortical carcinoma (ACC), the second most aggressive malignant tumor, lacks epidemiological data worldwide; therefore, every new case can improve the understanding of the pathology and treatment of this malignancy.
CASE SUMMARY We present the case of a 66-year-old Caucasian woman with a giant androgen-producing ACC (21 cm × 17 cm × 12 cm; 2100 g), without metastases, which unusually presented with an acute onset of atrial flutter and congestive heart failure. The cardiac complications observed in our case support the hypothesis that androgen excess in women is a cardiovascular risk factor. Androgen excess in women can be a rare cause of reversible dilated cardiomyopathy, therefore a comprehensive approach to the patient is essential to improve the recognition of androgen-secreting ACC. The atrial flutter was remitted after initiation of drug treatment during admission. The severe heart failure was totally remitted at 6 mo after radical open surgery to remove the giant ACC.
CONCLUSION Radical open surgery to remove a giant androgen-producing ACC was the first-line treatment to cure the excess of androgen, which determined the total remission of cardiac complications at 6 mo after surgery in the women of this case report.
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Affiliation(s)
- Mircea-Florin Costache
- Surgery Clinic, Saint Spiridon University Clinical Emergency Hospital, Iasi 700111, Romania
| | - Raluca-Elena Arhirii
- Cardiology Clinic, Saint Spiridon University Clinical Emergency Hospital, Iasi 700111, Romania
| | - Simona-Juliette Mogos
- Department of Endocrinology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
- Endocrinology Clinic, Saint Spiridon University Clinical Emergency Hospital, Iasi 700111, Romania
| | - Corina Lupascu-Ursulescu
- Department of Radiology and Imaging Sciences, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
- Radiology Clinic, Saint Spiridon University Clinical Emergency Hospital, Iasi 700111, Romania
| | | | - Adi-Ionut Ciumanghel
- Anesthesia and Intensive Care Department, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
- Anesthesia and Intensive Care Department, Saint Spiridon University Clinical Emergency Hospital, Iasi 700111, Romania
| | - Catalina Cucu
- Histopatology Department, Saint Spiridon University Clinical Emergency Hospital, Iasi 700111, Romania
| | - Cristina-Mihaela Ghiciuc
- Department of Pharmacology, Clinical Pharmacology and Algesiology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Antoniu-Octavian Petris
- Cardiology Clinic, Saint Spiridon University Clinical Emergency Hospital, Iasi 700111, Romania
- Department of Cardiology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Nicolae Danila
- Surgery Clinic, Saint Spiridon University Clinical Emergency Hospital, Iasi 700111, Romania
- Surgery Clinic, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
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Lam AKY. Adrenocortical Carcinoma: Updates of Clinical and Pathological Features after Renewed World Health Organisation Classification and Pathology Staging. Biomedicines 2021; 9:biomedicines9020175. [PMID: 33578929 PMCID: PMC7916702 DOI: 10.3390/biomedicines9020175] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 12/20/2022] Open
Abstract
Adrenocortical carcinoma (ACC) is a heterogenous group of diseases with different clinical behaviour between adult and paediatric patients. In addition, three histological variants, oncocytic, myxoid and sarcomatoid are noted on the recent World Health Organisation (WHO) classification of ACC. A review of recent literature showed that the different types of ACC have distinctive demographic data, clinical presentation, pathology, biological behaviour, genomic and patients' prognosis. In addition, recent updates of pathology staging for ACC allow refinement of prognostic grouping for planning treatment of the patients with ACC. These advances in genomic, pathology and staging have driven the development of standardisation of pathology reporting. International standardisation of pathological reporting of adrenocortical carcinoma and adaption to local pathology communities provide universal platforms for clinicians and researchers involved in the management of patients with ACC. To conclude, all these advances in the field of pathology will improve development of management strategies including improvement of clinical care, development of prognostic markers and testing of novel therapeutic approaches for patients with adrenocortical carcinoma.
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Affiliation(s)
- Alfred King-yin Lam
- School of Medicine, Griffith University, Gold Coast, QLD 4222, Australia;
- Pathology Queensland, Gold Coast University Hospital, Southport, Gold Coast, QLD 4215, Australia
- Faculty of Medicine, The University of Queensland, Herston, Brisbane, QLD 4006, Australia
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