case_images: PMC8062207_01
case_images: Abdominal computed tomography scan. The red arrow indicates the left adrenal tumor (diameter, 7 cm). The yellow arrows indicate multiple liver tumors (diameter, ~4 cm).
case_images: CRIE2021-5584198.001.jpg
case_images: PMC8062207_01_CRIE2021-5584198.001.jpg
case_images: fig1
case_images: Results of histopathological and immunohistochemical investigation of left adrenal and liver biopsy specimens (magnification, x200). Microscopic appearance (hematoxylin and eosin, HE, staining) showed eosinophilic tumor cell cytoplasm, nuclear atypia, diffuse architecture, and sinusoidal invasion. Immunohistochemical staining showed strong positive reactivity for SF-1, P450c17, 3betaHSD2, P450c21, CYP11B1, and CYP11B2 and partial positive reactivity for P450scc and 3betaHSD1 in both the left adrenal tumor (upper panel) and the liver tumor (lower panel). The DHEA-ST test result was negative for both specimens.
case_images: CRIE2021-5584198.002.jpg
case_images: PMC8062207_01_CRIE2021-5584198.002.jpg
case_images: fig2
case_images: Immunohistochemical investigation showed strong positive staining for SF-1, P450c17, P450c21, 3betaHSD2, CYP11B1, and CYP11B2 and partial positive staining for P450scc and 3betaHSD1 in both the ACC and the liver metastases (Figure 2); these findings indicated synthetic capability for aldosterone and cortisol.