Adrenal cortical carcinoma
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Adrenal cortical carcinoma
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A 44-year-old man comes to his physician complaining of muscle weakness and headaches for the past 2 months. He is a construction worker and has found it difficult to lift large objects during the job. The patient has no significant past medical history, but he states his blood pressure was “high” at a recent health fair. Temperature is 37.0°C (98.6°F), pulse is 82/min, and blood pressure is 165/92 mm Hg. Physical examination reveals no abnormalities. Laboratory testing reveals the following findings:
Serum renin levels are decreased. Which of the following is the most likely cause of this patient’s condition?
| Laboratory Value | Result |
| Serum | |
| Sodium | 147 mEq/L |
| Potassium | 2.9 mEq/L |
| Chloride | 105 mEq/L |
| HCO3- | 32 mEq/L |
| Creatinine | 0.6 mg/dL |
| Glucose | 94 mg/dL |
Serum renin levels are decreased. Which of the following is the most likely cause of this patient’s condition?
Summary
Adrenal cortical carcinomas are rare tumors that arise from the outer layer of the adrenal gland called the adrenal cortex. They account for only about 1% of all cancers.
Adrenal cortical tumors can be either benign (noncancerous) or cancerous. The most common type of adrenal cortical tumor is a pheochromocytoma, arising from the chromaffin cell, which produces the hormone adrenaline.
Symptoms of an adrenal cortical carcinoma depend on the type but may include: feeling very tired, weight loss, truncal obesity, muscle weakness, and blood in the urine.