Virilising adrenocortical carcinoma: BMJ Case Reports

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Adrenocortical carcinoma (ACC) is a rare malignancy, with an estimated annual incidence of 0.7-2 cases per million and a median overall survival of 3-4 years. Hormone-secreting ACCs represent most cases; of these, only a small minority presents with virilisation alone. Early diagnosis is key to increase the chances of a better outcome. Here, we report a case of a 41-year-old woman who presented with menstrual irregularities, hirsutism and virilising symptoms, associated with abdominal discomfort and constitutional symptoms. On physical examination, there was a palpable mass in the right upper quadrant. Laboratory workup revealed elevated serum androgens. The imaging study showed a 163×110×122 cm right adrenal mass with features consistent with ACC and suggested potential hepatic invasion. Our patient underwent surgical resection, and the histopathological findings confirmed the diagnosis. She was referred to a specialised centre for follow-up and adjuvant therapy. ©
Original languageEnglish
Article numbere242895
JournalBMJ case reports
Issue number6
Publication statusPublished - 2 Jun 2021


  • adrenal disorders
  • endocrine cancer
  • general surgery
  • surgical oncology
  • antineoplastic agent
  • mitotane
  • androgen
  • abdominal mass
  • abdominal pain
  • adrenal cortex carcinoma
  • adrenalectomy
  • adult
  • anorexia
  • Article
  • asthenia
  • cancer adjuvant therapy
  • cancer incidence
  • cancer staging
  • case report
  • cholecystectomy
  • clinical article
  • clinical feature
  • clitoris hypertrophy
  • diaphoresis
  • early diagnosis
  • female
  • follow up
  • hirsutism
  • human
  • human tissue
  • liver nodule
  • liver resection
  • low back pain
  • overall survival
  • physical examination
  • positron emission tomography
  • prevalence
  • tumor invasion
  • virilization
  • adrenal cortex tumor
  • diagnostic imaging
  • gonadal disease
  • liver
  • Adrenal Cortex Neoplasms
  • Adrenocortical Carcinoma
  • Adult
  • Androgens
  • Female
  • Humans
  • Liver
  • Virilism


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