HUGE HEMATOMA AS FIRST MANIFESTATION OF ADRENOCORTICAL CARCINOMA: A CASE REPORT siavashfeiz@gmail.com

PE096

HUGE HEMATOMA AS FIRST MANIFESTATION OF ADRENOCORTICAL CARCINOMA: A CASE REPORT

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Poland

Poster Exhibition only

Adrenocortical carcinoma is a rare malignancy with a poor prognosis, often detected in middle-aged adults. The disease manifests in various ways, typically via hormone-related symptoms, mass effects, or incidental findings on imaging. Hemorrhages within ACCs are rare and can complicate diagnosis and treatment, requiring surgical resection as the primary therapeutic option.

This case involved a 38-year-old male admitted with acute right flank pain, where initial imaging revealed a large adrenal hematoma. With no evidence of malignancy in preoperative tests, a conservative approach was initially adopted. Following a multidisciplinary review, the patient underwent elective adrenalectomy after a 25-day stabilization period

Surgical resection confirmed ACC with hemorrhage as its first symptom. Postoperative pathology identified low proliferation and mitotic activity, and the patient began adjuvant therapy, demonstrating stable recovery without complications.

Adrenal hemorrhage, although uncommon, can signal malignancy even when imaging and labs show no malignancy markers. Prompt elective surgery in stable patients with adrenal hemorrhage may enable early cancer detection and improve outcomes.