{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:00:53Z","timestamp":1790283653448,"version":"4.1.0"},"reference-count":5,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Adrenocortical carcinoma is a rare malignancy (0.5\u20132 cases\/million\/year) with a poor prognosis. Hypercortisolism, virilization, and compressive features are among the common presentations of adrenocortical carcinoma. Hematuria is one of the rare initial presentations of adrenocortical carcinoma reported in the literature. We report a case of adrenal carcinoma presenting with microscopic hematuria.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 67-year-old Sri Lankan patient with diabetes, hypertension, and ischemic heart disease presented with an acute coronary event. During the routine evaluation, microscopic hematuria was detected without proteinuria or active sediments. She denied any painful micturition, previous similar episodes, or abdominal pain. Further evaluation revealed a hypokalemia with biochemical evidence of hypercortisolism and high testosterone levels with suppressed adrenocorticotropic hormone levels. On imaging, there was evidence of a right suprarenal mass 7\u00a0cm\u00a0\u00d7\u00a03\u00a0cm\u00a0\u00d7\u00a06\u00a0cm in size that was hypoechoic and lobulated and suggestive of a lipid-poor tumor. She underwent adrenalectomy. By the time of surgery 3\u00a0weeks\u00a0later, significant weight gain with features of Cushing syndrome, including hirsutism, skin atrophy, easy bruising without virilization, and proximal myopathy, were noted. Histology identified a right-sided adrenal tumor with capsular and vascular invasion. Hypercortisolism and hematuria disappeared after surgery. The patient was referred for further oncological management.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This case illustrates a rare presentation of adrenal carcinoma. Awareness of this presentation may facilitate early evaluation and management.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-022-03398-4","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T13:04:57Z","timestamp":1653915897000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Adrenal carcinoma: a case report"],"prefix":"10.1186","volume":"16","author":[{"given":"D. R.","family":"Abeynayake","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sopan","family":"V","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. J. C.","family":"Perera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Paramanantham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. M. J.","family":"Munasinghe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"issue":"2","key":"3398_CR1","doi-asserted-by":"publisher","first-page":"161","DOI":"10.4103\/0970-1591.174782","volume":"32","author":"R Yadav","year":"2016","unstructured":"Yadav R, Dassi V, Kumar A. Adrenocortical carcinoma with inferior vena cava thrombus: renal preserving surgery. Indian J Urol. 2016;32(2):161\u20133. https:\/\/doi.org\/10.4103\/0970-1591.174782.","journal-title":"Indian J Urol."},{"issue":"4","key":"3398_CR2","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1530\/EJE-18-0608","volume":"179","author":"M Fassnacht","year":"2018","unstructured":"Fassnacht M, Dekkers OM, Else T, Baudin E, Berruti A, de Krijger R, Haak HR, Mihai R, Assie G, Terzolo M. European Society of Endocrinology Clinical Practice Guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2018;179(4):G1\u201346. https:\/\/doi.org\/10.1530\/EJE-18-0608.","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"3398_CR3","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1002\/(SICI)1097-0142(20000215)88:4<711::AID-CNCR1>3.0.CO;2-W","volume":"88","author":"BL Wajchenberg","year":"2000","unstructured":"Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA, Zerbini MC, Liberman B, Carlos Gomes G, Kirschner MA. Adrenocortical carcinoma: clinical and laboratory observations. Cancer. 2000;88(4):711\u201336.","journal-title":"Cancer"},{"key":"3398_CR4","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1002\/(SICI)1097-0142(20000215)88:4<711::AID-CNCR1>3.0.CO;2-W","volume":"88","author":"BL Wajchenberg","year":"2000","unstructured":"Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Carneiro PC, Ferreira Alves VA, Zerbini MCN, Liberman B, Gomes GC, Kirschner MA. Adrenocortical carcinoma. Cancer. 2000;88:711\u201336.","journal-title":"Cancer"},{"issue":"1","key":"3398_CR5","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1038\/sj.jhh.1001105","volume":"15","author":"AN Dixon","year":"2001","unstructured":"Dixon AN, Bing RF. Two cases of adrenocortical carcinoma presenting as Conn\u2019s syndrome. J Hum Hypertens. 2001;15(1):75\u20139. https:\/\/doi.org\/10.1038\/sj.jhh.1001105.","journal-title":"J Hum Hypertens"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03398-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-022-03398-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03398-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T13:13:29Z","timestamp":1653916409000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-022-03398-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,30]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["3398"],"URL":"https:\/\/doi.org\/10.1186\/s13256-022-03398-4","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,30]]},"assertion":[{"value":"3 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 April 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable for case reports","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"229"}}