Adrenocortical Carcinoma with Sarcomatoid and Oncocytic Differentiation—A Rare Case Report with Review of Literature

Abstract

Introduction: Adrenocortical carcinoma is a rare endocrine malignant neoplasm with an estimated incidence of 0.5–2.0 cases per million per year. It is more common in adults (females) with a peak in the fifth decade of life.  Case Report: A 35 year old male presented to the emergency department with left abdominal pain, weakness, decreased appetite and weight loss for 2 years and intermittent fever for 5 months. On examination, he was found to have pallor, palpitation and a diffuse, tender, fixed and firm to hard swelling in the left lumbar and iliac region. On histopathological examination, it was diagnosed as Adrenocortical Carcinoma with Sarcomatoid and oncocytic differentiation. Immunohistochemistry confirmed the same. Conclusion: As Adrenocortical carcinosarcoma is an extremely rare neoplasm with a poor prognosis, accurate diagnosis is of utmost importance. Surgical management is the main modality of treatment.