Cytological diagnosis of Adrenocortical Carcinoma with metastatic lesion in liver

  • Vasudha M Bhagat Govt. Medical College, Surat.
  • Hemali J Tailor Government Medical College, Surat, Gujarat, India
  • Reena B Dudhat Govt. Medical College, Surat.
  • Ravi M Unjiya Govt. Medical College, Surat.
Keywords: Adrenocortical carcinoma, FNAC, Immunocytochemistry, Liver matastasis,


Adrenocortical Carcinoma (ACC) is rare tumor with a reported incidence of 2 cases per million individuals per year. These tumors are highly aggressive and at the time of diagnosis, these are at higher stage. Here, we report a case of adrenal mass and multiple hypodense lesions in liver detected on imaging study which on subsequent USG-guided fine needle aspiration cytology (FNAC) performed from adrenal glands and liver turned out to be a ACC with metastatic lesion by using immunocytochemistry as an ancillary technique which showed tumor cells immunoreactivity for inhibin and calretinin; and negativity for cytokeratin, vimentin and epithelial membrane antigen (EMA) thus confirming the suspected morphological diagnosis and highlighting the accuracy of FNAC as a diagnostic tool.   

Author Biographies

Vasudha M Bhagat, Govt. Medical College, Surat.
Additional Professor Department Of Pathology
Hemali J Tailor, Government Medical College, Surat, Gujarat, India
Assistant professor, Dept of Pathology
Reena B Dudhat, Govt. Medical College, Surat.
Senior residentDepartment Of Pathology
Ravi M Unjiya, Govt. Medical College, Surat.
Senior residentDepartment Of Pathology


1. Fassnacht M, Allolio B. Clinical management of adrenocortical carcinoma. Best Pract Res ClinEndocrinolMetab2009; 23: 273–89
2. Sandrini R, Ribeiro RC, DeLacerda L. Childhood adrenocortical tumors. J Cli-nEndocrinolMetab 1997; 82:2027–31
3. Wooten MD, King DK. Adrenal cortical carcinoma: Epidemiology and treatment with mitotane and a review of the litera-ture. Cancer 1993; 72:3145-55
4. Ng L, Libertino JM. Adrenocortical carcinoma: Diagnosis, evaluation and treatment. J Urol 2003; 169:5-11
5. Icard P, Chapuis Y, Andreassian B, Ber-nard A, ProyeC. Adrenocortical carcinoma in surgically treated patients: A retrospective study on 156 cases by theFrench Association of Endocrine Surgery. Surgery 1992; 112:972-9
6. Icard P, Goudet P, Charpenay C, An-dreassian B, Carnaille B, Chapuis Y, et al. Adrenocortical carcinomas: surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons Study Group. World J Surg. 2001; 25: 891-7
7. Centeno BA. Pathology of liver metastases. Cancer Control 2006;13:13-26
8. Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA, et al: Adrenocortical carcinoma: Clinical and laboratory observations. Cancer 2000; 88:711-36.
9. Dang C, Mohamed H, Mandal A, Salem F. Adrenal cortical carcinoma: A case of late pulmonary metastasis. J Nat Med Assoc 2001; 93:37-9.
10. Orlando R, Pelizzo MR, Lirussi F. Adrenocortical carcinoma: A 15-year survival after complete resection and repeated resection. A retrospective study in a patient with an expected poor prognosis. Anticancer Res 2003; 23:2929-31.
Case Report