Adrenocortical cancer: late diagnosis of the disease on the example of a clinical case. Case report
- Authors: Starostina E.A.1, Molashenko N.V.1, Levshina A.R.2, Pachuashvili N.V.1,2, Chevais A.1, Isaeva M.P.1, Getazheev K.V.3, Beltsevich D.G.1, Platonova N.M.1, Troshina E.A.1
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Affiliations:
- Endocrinology Research Centre
- Sechenov First Moscow State Medical University (Sechenov University)
- Pirogov Russian National Research Medical University
- Issue: Vol 95, No 12 (2023)
- Pages: 1179-1184
- Section: Clinical notes
- URL: https://journals.rcsi.science/0040-3660/article/view/258746
- DOI: https://doi.org/10.26442/00403660.2023.12.202430
- ID: 258746
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Abstract
Adrenocortical carcinoma (ACC) is a rare malignant tumor originating in the adrenal cortex and characterized by poor 5-year survival. It occurs with a frequency of 2–4 cases per 2 million in the population. Women are more frequently affected than men and it is mostly detected in the fourth and fifth decades. In the most of cases, the cancerogenesis occurs sporadically because of gene driver mutations in somatic adrenocortical cells, in other cases it can be found as part of a genetically determined syndrome such as Li–Fraumeni syndrome or Wermer's syndrome (multiple endocrine adenomatosis type I). ACC most frequently happens occurs without symptoms in the initial stages leading to poor diagnoses. Because of this lack of early detection, the tumor is not considered malignant reducing the benefits of further treatment. Sometimes the fact that the resected tumor is indeed adrenocortical carcinoma becomes clear only after recurrence, or after the appearance of metastases. We present a case of adrenocortical carcinoma in a 46-year-old woman who went to the doctor in 1.5 year after symptoms were manfested. This clinical case illustrates the consequences of late diagnosis of a malignant tumor. We would like to emphasize the importance of timely detection of a neoplasm, using all of the potential of laboratory-instrumental and genomic analysis. Due to low oncological awareness, our patient was slow to seek medical help, which in turn led not only to metastases, but also to complications in the cardiovascular system.
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##article.viewOnOriginalSite##About the authors
Evgenia A. Starostina
Endocrinology Research Centre
Author for correspondence.
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0003-2283-8958
врач-эндокринолог, сотр. Координационного совета ФГБУ «НМИЦ эндокринологии»
Russian Federation, MoscowNatalya V. Molashenko
Endocrinology Research Centre
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0001-6265-1210
канд. мед. наук, вед. науч. сотр.
Russian Federation, MoscowAnna R. Levshina
Sechenov First Moscow State Medical University (Sechenov University)
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0002-9315-3801
студентка
Russian Federation, MoscowNano V. Pachuashvili
Endocrinology Research Centre; Sechenov First Moscow State Medical University (Sechenov University)
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0002-8136-0117
мл. науч. сотр. лаб. эндокринной биофотоники ФГБУ «НМИЦ эндокринологии»; ординатор Института клинической морфологии и цифровой патологии ФГАОУ ВО «Первый МГМУ им. И. М. Сеченова» (Сеченовский Университет)
Russian Federation, Moscow; MoscowAnastassia Chevais
Endocrinology Research Centre
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0001-5592-4794
аспирант
Russian Federation, MoscowMariya P. Isaeva
Endocrinology Research Centre
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0002-9963-6783
аспирант
Russian Federation, MoscowKantemir V. Getazheev
Pirogov Russian National Research Medical University
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0001-5193-0556
клин. ординатор
Russian Federation, MoscowDmitry G. Beltsevich
Endocrinology Research Centre
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0001-7098-4584
д-р мед. наук, проф., гл. науч. сотр. отд. хирургии
Russian Federation, MoscowNadezhda M. Platonova
Endocrinology Research Centre
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0001-6388-1544
д-р мед. наук, проф., зав. отд. терапевтической эндокринологии
Russian Federation, MoscowEkaterina A. Troshina
Endocrinology Research Centre
Email: colpakova.ev@mail.ru
ORCID iD: 0000-0002-8520-8702
чл.-кор. РАН, д-р мед. наук, проф., зам. дир. – дир. Института клинической эндокринологии
Russian Federation, MoscowReferences
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