A Case of Primary Adrenocortical Carcinoma Resected by a Diagnosis of Adrenal Metastasis of Gastric Cancer

Abstract

A 70-year-old woman underwent laparoscopic distal gastrectomy for early gastric cancer on the lesser curvature of the gastric angle. The tumor was pathologically diagnosed as Stage I B (moderately differentiated adenocarcinoma, pT1b1(SM1), pN1(#1), H0, P0, M0). Abdominal CT scan before gastrectomy revealed an adrenal incidentaloma which showed a tendency to grow on another CT scan 6 months after gastrectomy. The tumor was suspected of malignancy from the results of MRI and PET-CT scan. Since there were no findings suggestive of distant or lymph node metastases, the patient was diagnosed as having isolated left adrenal metastasis from gastric cancer, and underwent laparoscopic left adrenalectomy. The histological diagnosis was primary non-functioning adrenocortical carcinoma, pT1N0M0 Stage I B.

Adrenocortical carcinoma is a rare disease and the preoperative diagnosis is often difficult if it is non-functioning.