Adrenal cortical carcinomas with multiple subcutaneous metastasis as the initial symptom:a case report
ZHENG Jiao
LI Chang-xin
LI Qian
WU Si-meng
MENG Si-hong
LI Qin-na
WANG Gong-wei
Abstract：Objective To discuss the clinical and pathological features of adrenocortical carcinoma. Methods A case of adrenocortical carcinoma was collected, and related literature was reviewed. Results The patient was a 71-year-old male who had discovered multiple subcutaneous nodules for one month. PET/CT showed a mass in the left adrenal region, with multiple metastases in the whole body lymph nodes, subcutaneous tissue, intermuscular and intramuscular spaces, bones, and brain. Under the microscope, the tumor cells showed infiltrative growth, with large geographic necrosis, arranged in solid sheets, nests, or alveolar patterns. Some cytoplasm were clear, some were short spindle-shaped. The cells showed severe nuclear atypia, with prominent nucleoli, 10 mitotic figures per 50 HPF, vascular tumor embolus and nerve invasion were observed. Immunohistochemistry and special staining: AE1/AE3, EMA, Vimentin, alpha-inhibin, GATA3 showed diffuse positive expression; MelanA, Syn, BRG1, INI1 showed partial positive expression; p53 showed mutant type; Ki-67 proliferation index was 80%. Reticular fiber staining showed partial rupture of reticular fibers between tumor cells. Conclusion Adrenocortical carcinoma presenting with multiple subcutaneous metastases as the initial clinical manifestation is rare. Diagnosis should be based on clinical data, imaging, and pathological examination, while excluding various differential diagnoses.
Keywords：Adrenal tumorsAdrenocortical carcinomaSubcutaneous metastasisPathological diagnosis
Publication Date：2025-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 612-614 )