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김향,이상종,정을순,김명숙,백문철,전승준 대한내분비학회 1990 Endocrinology and metabolism Vol.5 No.3
Adrenal cortical carcinoma is a rare malignancy occuring at a rate of only two cases per million population per years, accounting for 0.02% of all cancers. Although the tumor can occur at any age, adrenal cortical carcinoma is most frequently seen in patients older than 40 years of age. The presenting symptoms of this tumor are abdominal pain, mass, loss of weight or fever of unknown origin. Several diagnostic modalities including computerized tomography, sonography, MRI scanning and aortogram are widely being used. A 51-year-old farmer was admitted to this hospital in December, 1989, because of epigastric pain and palpable mass in the upper abdomen with duration of 3years. He had not received any special study or treatment for the presenting symptoms except intermittent administration of oral digestives at drugstore. Physical examination was essentially normal except mass in the upper abdomen with unremarkable border, smooth surface. It was slightly tender and not movable. At the outpatient department, he had received gastrofiberscopy and it showed a small ulcer on the pyloric antrum. Routine laboratory examination including blood chemistry gave no abnormalities. An ultrasonographic examination showed two cystic mass in the body and tail of the pancrease. Computerized tomographic finding of the abdoman suggested the diagnosis of pancreatic pseudocyst. However, the possibility of adrenal tumor could not be ruled out. On the surgical approach, the systic lesion was found to be a mass of the adrenal gland and its cavity was consisted of blood clot and necrotic tissue. The adrenal gland with cystic mass was removed without any difficulty and pathological examination disclosed an adrenal cortical carcinoma with capsular invasion. Convalescene was not eventful and she had discharged 2 weeks after surgery and she was discharged 2 weeks after surgery and has been given anticancer chemotherapy periodically. (J Kor Soc Endocrinol 5:220~225, 1990)