Functional adrenocortical carcinoma: Case report

The suprarrenal carcinoma is a rare disease. More than 60% of those tumors are functional: Cushing's syndrome (45%), Cushing and virilization (25%), virilization alone (10%, in children more than 85%). Nonfunctional tumors occur as incidentalomas in advanced age and have worse prognosis. It is diagnosed by CT o MRI. Functional tumors must to be show hypercortisolism. Potentially curative treatment is surgical resection. Advanced disease has poor response to mitotane and chemotherapy. Adrenal insufficiency post resection should be avoided with use of steroids. We present a female 34 year-old, whit morbid obesity (BMI: 55 kg/m(2)), hypertension, hypotiroidism, venous insufficiency and varicose ulcers, amenorrhea, hirsutism and dermatitis acneiform. Laboratories test detected hypercortisolism and an abdominal CT scan showed a giant left adrenal tumor. She underwent left adrenalectomy- nefrectomy, splenectomy and distal pancreatectomy. During postsurgical period developed acute kidney injury requiring hemodialysis, which exacerbate the postoperative adrenal insufficiency and died at the five day. It is important detect this condition in early stages due survival rates at 5 years are: Stage I 82%, Stage II 61%, Stage III 50% y Stage IV 13%. Without resection the survival rate is 6-9 months, even whit the use of mitotane; its main benefit is to decrease symptoms of hypercortisolism. Currently the survival has been improved with adequate surgical resection and adjuvant therapy whit mitotane and cytotoxic drugs.