{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:49:03Z","timestamp":1755218943333,"version":"3.43.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/ http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Introduction:<\/jats:title>\n            <jats:p>Adrenal tumors are very common, affecting 3\u201310% of the human population, and most are small, benign, nonfunctional adrenocortical adenomas. Adrenocortical carcinoma (ACC), in contrast, is a very rare disease. The median age of diagnosis is in the fifth to sixth decade. There is a predilection for the female gender (the ratio of female to male ranges from 1.5 to 2.5\u00a0:\u00a01) the adult.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation:<\/jats:title>\n            <jats:p>A 28-year-old man who had no prior history of systemic hypertension or diabetes mellitus presented with bilateral limb swelling for 2 months and facial puffiness for 1 month. He had an episode of hypertensive emergencies. A radiological and hormonal work-up established the diagnosis of primary ACC. One cycle of chemotherapy was given until he lost follow-up and succumbed to death due to financial constraints.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Adrenocortical carcinoma is an extremely uncommon tumor of the adrenal gland, and it is even more uncommon when it manifests without any symptoms. If patients exhibit signs of rapid and multiple adrenocortical hormone excess, such as weakness, hypokalaemia, or hypertension, ACC may be suspected. Recently developed gynecomastia in men may be brought on by an ACC producing too much sex hormone. To accurately diagnose the condition and give the patient a fair prognosis, a multidisciplinary approach involving endocrine surgeons, oncologists, radiologists, and internists is advised. Proper genetic counseling is recommended. It is critical to know whether the adrenal mass is malignant or not, and to get this ascertained by a computed tomography finding and biopsy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ms9.0000000000000097","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T10:19:33Z","timestamp":1680085173000},"page":"1834-1838","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Primary adrenocortical carcinoma: a case report"],"prefix":"10.1097","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-9335","authenticated-orcid":false,"given":"Durga","family":"Neupane","sequence":"first","affiliation":[{"name":"Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9242-0579","authenticated-orcid":false,"given":"Sarada","family":"Khadka","sequence":"additional","affiliation":[{"name":"Surgery (Breast, Endocrine and General Surgery)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1148-6002","authenticated-orcid":false,"given":"Paricha","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh P.","family":"Sah","sequence":"additional","affiliation":[{"name":"Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8424-2108","authenticated-orcid":false,"given":"Soniya","family":"Dulal","sequence":"additional","affiliation":[{"name":"Internal Medicine (Medical Oncology), B.P. Koirala Institute of Health Sciences, Dharan, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siddhartha K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ujjwal K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,5]]},"reference":[{"key":"R1-20250806","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1210\/er.2002-0031","article-title":"The clinically inapparent adrenal mass: update in diagnosis and management","volume":"25","author":"Mansmann","year":"2004","journal-title":"Endocr Rev"},{"key":"R2-20250806","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/j.ijrobp.2008.10.091","article-title":"Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials","volume":"74","author":"Viani","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R3-20250806","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1210\/jc.2005-2639","article-title":"Clinical review: adrenocortical carcinoma: clinical update","volume":"91","author":"Allolio","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"R4-20250806","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1007\/s00268-005-0329-x","article-title":"Extent of disease at presentation and outcome for adrenocortical carcinoma: have we made progress?","volume":"30","author":"Kebebew","year":"2006","journal-title":"World J Surg"},{"key":"R5-20250806","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.beem.2008.10.008","article-title":"Clinical management of adrenocortical carcinoma","volume":"23","author":"Fassnacht","year":"2009","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"R6-20250806","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1056\/NEJM199004263221705","article-title":"Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy","volume":"322","author":"Luton","year":"1990","journal-title":"N Engl J Med"},{"key":"R7-20250806","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1200\/JCO.2004.08.085","article-title":"Clinical and outcome characteristics of children with adrenocortical tumors: a report from the International Pediatric Adrenocortical Tumor Registry","volume":"22","author":"Michalkiewicz","year":"2004","journal-title":"J Clin Oncol"},{"key":"R8-20250806","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1200\/JCO.2002.20.4.941","article-title":"Adrenocortical carcinoma: clinical, morphologic, and molecular characterization","volume":"20","author":"Stojadinovic","year":"2002","journal-title":"J Clin Oncol"},{"key":"R9-20250806","first-page":"55","article-title":"Adrenocorticalcarcinoma","volume":"65","author":"van Ditzhuijsen","year":"2007","journal-title":"Neth J Med"},{"key":"R10-20250806","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int J Surg"},{"key":"R11-20250806","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1210\/er.2013-1029","article-title":"Adrenocortical carcinoma","volume":"35","author":"Else","year":"2014","journal-title":"Endocr Rev"},{"key":"R12-20250806","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1148\/rg.295095027","article-title":"Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls","volume":"29","author":"Johnson","year":"2009","journal-title":"Radiographics"},{"key":"R13-20250806","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/cncr.24030","article-title":"Limited prognostic value of the 2004 International Union Against Cancer staging classification for adrenocortical carcinoma: proposal for a Revised TNM Classification","volume":"115","author":"Fassnacht","year":"2009","journal-title":"Cancer"},{"key":"R14-20250806","doi-asserted-by":"crossref","first-page":"W706","DOI":"10.2214\/AJR.10.5540","article-title":"Adrenocortical carcinoma: the range of appearances on CT and MRI","volume":"196","author":"98. 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