A case of primary adrenocortical carcinoma with elevated serum cea

Abstract

We report our experience with a case of primary adrenocortical carcinoma with elevated serum CEA. The patient was a 54-year-old man who visited a local doctor with a chief complaint of right hypochondriac pain. After a tumor was detected in the right adrenal gland on abdominal CT, the patient was referred to our hospital for detailed examination and treatment. Tests following admission showed an abnormally high CEA (a tumor marker) level of 387 ng/ml. CT revealed a tumor 6 cm in diameter in the right adrenal gland with heterogeneous contrast enhancement inside the tumor. On MRI, T1-weighted imaging showed low signal intensity while T2-weighted imaging showed heterogeneous high signal intensity inside the tumor. On adrenocortical scintigraphy, RI uptake was reduced in the right adrenal gland, while adrenal hormone levels were normal. Based on the above, the patient was diagnosed with non-functional adrenocortical tumor and the tumor was surgically resected. The resected tumor was 6×4×3 cm in size and was histopathologically diagnosed as adrenocortical carcinoma. CEA immunostaining revealed densely stained tumor cells. CEA level returned to normal after three months postoperatively, and no recurrence has occurred at three years postoperatively. As few cases of adrenocortical carcinoma with elevated serum tumor markers have been reported in Japan, we consider the present report valuable.