{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:31:13Z","timestamp":1787059873071,"version":"build-2736575974"},"reference-count":13,"publisher":"Bioscientifica","issue":"2","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":93,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Adrenocortical carcinomas (ACCs) are a very rare entity with an incidence of approximately 0.5\u20132 cases per million per year. They are often difficult to diagnose clinically, attributing to non-specific signs and symptoms, especially with non-functioning tumours, with histopathology required for confirmatory diagnosis. Atraumatic adrenal haemorrhage has been described in the literature as a rare presentation of ACC. We describe a case of a gentleman in his fifties presenting with acute spontaneous unilateral adrenal haemorrhage on a background of a pre-existing known incidental adrenal nodule that was lost to follow-up. The patient underwent angio-embolisation and subsequent laparoscopic adrenalectomy, with histopathology demonstrating ACC. This report aims to highlight adrenal haemorrhage as a presenting feature of ACC and stress the importance of close follow-up and thorough initial investigation of adrenal nodules to ascertain their underlying aetiology and ultimately prevent delay in appropriate management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1530\/edm-25-0085","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T09:56:04Z","timestamp":1777283764000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Non-functioning adrenocortical carcinoma presenting as acute spontaneous retroperitoneal haemorrhage"],"prefix":"10.1530","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6416-7498","authenticated-orcid":true,"given":"Christopher","family":"Chan","sequence":"first","affiliation":[{"name":"The University of Sydney School of Medicine, Sydney, Australia 1"},{"name":"Department of Endocrinology and Metabolism, Concord Repatriation General Hospital, Sydney, Australia 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee C F","family":"Chan","sequence":"additional","affiliation":[{"name":"The University of Sydney School of Medicine, Sydney, Australia 1"},{"name":"Department of Anatomical Pathology, Concord Repatriation Hospital, Sydney, Australia 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1637-5117","authenticated-orcid":true,"given":"Mawson","family":"Wang","sequence":"additional","affiliation":[{"name":"The University of Sydney School of Medicine, Sydney, Australia 1"},{"name":"Department of Endocrinology and Metabolism, Concord Repatriation General Hospital, Sydney, Australia 2"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"2026081809180262200_bib1","doi-asserted-by":"crossref","first-page":"636","DOI":"10.14740\/jocmr3503w","article-title":"The characteristics and trends in adrenocortical carcinoma: a United States population based study","volume":"10","author":"Sharma","year":"2018","journal-title":"J Clin Med Res"},{"key":"2026081809180262200_bib2","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1210\/endrev\/bnaa008","article-title":"Adrenal incidentaloma","volume":"41","author":"Sherlock","year":"2020","journal-title":"Endocr Rev"},{"key":"2026081809180262200_bib3","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1093\/ejendo\/lvad066","article-title":"European Society of Endocrinology clinical practice guidelines on the management 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international, multicentre, open-label, randomised, phase 3 trial and observational study","volume":"11","author":"Terzolo","year":"2023","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026081809180262200_bib10","article-title":"Efficacy and safety of adjuvant radiation therapy in localized adrenocortical carcinoma","volume":"14","author":"Wu","year":"2023","journal-title":"Front Endocrinol"},{"key":"2026081809180262200_bib11","doi-asserted-by":"crossref","first-page":"306","DOI":"10.12701\/jyms.2024.00626","article-title":"Ruptured triple hormone-secreting adrenal cortical carcinoma with hyperaldosteronism, hypercortisolism, and elevated normetanephrine: a case report","volume":"41","author":"Woo","year":"2024","journal-title":"J Yeungnam Med Sci"},{"key":"2026081809180262200_bib12","doi-asserted-by":"crossref","first-page":"974","DOI":"10.3349\/ymj.2010.51.6.974","article-title":"Spontaneous rupture of a functioning adrenocortical 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