When the Little Dreams Become Huge Nightmares : A Case Report of a Huge Adrenocortical Carcinoma

Background: Adrenocortical carcinoma is a very rare and aggressive tumor of the adrenal gland. It has a poor prognosis even in the form of localized disease. It presents mainly with signs of hormonal excess but it can present with metastases.

Case presentation: We report the case of a young woman who presented a Cushing syndrome with virilization. The clinical presentation, the biochemical tests, the imaging findings and the pathology studies altogether establish the diagnosis of a huge adrenocortical carcinoma at advanced stage with identified pulmonary lesions. The patient was started on mitotane and has received chemotherapy.

Conclusion: This case is presented because of its rarity, and to highlight the importance of combining the different aspects of the presentation mode of the disease in order to establish the diagnosis.