A 32-year-old man presented with long-standing low back pain that worsened in recent days, as well as loss of thirty pounds of body weight over a period of approximately three months.
No symptoms or signs of adrenal hyperfunction were detected.
Abdominal examination revealed a hard tumor in the left hypochondrium that reached the mesogastrium and left iliac fossa.
The imaging studies performed were: abdominal ultrasound, chest X-ray, descending urogram and computerized axial tomography.
No metastases were detected on chest X-ray.
The findings obtained in other imaging studies indicated the presence of an extensive well-defined mass with regular contours and heterogeneous signs suggestive of hemorrhagic and necrotic areas.
Displacement of neighboring structures was observed.
The liver and inferior vena cava were not affected.
Treatment consisted of surgical removal of the abdominal via clamping of the thoracic aorta to control transoperative bleeding.
We also performed resection of the tumor left nephrectomy and block resection with bundles of hiliar lymph nodes.
1.
The excised tumor was well encapsulated, with a weighed 4350 g and a maximum diameter of 24 cm.
Macroscopic examination showed a solid mass with hemorrhagic areas.
Tumor located the capsule and perirenal fat of the entire upper pole of the left kidney as well as the spleen.
Histological examination confirmed the diagnosis of adrenal carcinoma.
Postoperative evolution was satisfactory and the patient was discharged on the tenth day of surgery.
Survival was six months.
Death occurred due to disease progression.
