{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T08:54:34Z","timestamp":1782982474144,"version":"3.54.5"},"reference-count":27,"publisher":"Pensoft Publishers","issue":"1","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>Adrenocortical carcinoma (ACC) is a rare endocrine cancer that originates in the adrenal cortex, known for its capacity to produce hormones such as cortisol, aldosterone, estrogens, or androgens. These hormonal imbalances lead to a diverse array of clinical manifestations. This case report describes a middle-aged male patient presenting with a dual-hormone secreting ACC, characterized by the secretion of both androgens and cortisol. This hormonal profile resulted in Cushing syndrome along with symptoms of androgen excess, including bilateral lower limb edema, prolonged fatigue, and altered mental status. An extensive diagnostic evaluation, including clinical assessments, laboratory tests and imaging revealed the presence of an adrenal mass and lung metastases. Imaging-guided biopsy confirmed diagnosis of ACC with simultaneous androgen and cortisol secretion. This report enriches the sparse literature on dual-secreting ACC, highlighting the complexities in its diagnosis and management.<\/jats:p>","DOI":"10.3897\/folmed.67.e130505","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T12:59:33Z","timestamp":1740574773000},"source":"Crossref","is-referenced-by-count":2,"title":["Adrenocortical carcinoma with dual androgen and cortisol secretion"],"prefix":"10.3897","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0724-2890","authenticated-orcid":true,"given":"Areti","family":"Kalfoutzou","sequence":"first","affiliation":[{"name":"251 Air Force General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantelis","family":"Petroulakis","sequence":"additional","affiliation":[{"name":"251 Air Force General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0272-3259","authenticated-orcid":true,"given":"Adam","family":"Mylonakis","sequence":"additional","affiliation":[{"name":"Laikon General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asimina","family":"Restemi","sequence":"additional","affiliation":[{"name":"251 Air Force General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Chaleplidis","sequence":"additional","affiliation":[{"name":"251 Air Force General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Anagnou","sequence":"additional","affiliation":[{"name":"National and Capodistrian University of Athens, \u2018Attikon\u2019 University Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Tsikalakis","sequence":"additional","affiliation":[{"name":"National and Capodistrian University of Athens, \u2018Attikon\u2019 University Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaritis","family":"Tsantopoulos","sequence":"additional","affiliation":[{"name":"251 Air Force General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Mostratou","sequence":"additional","affiliation":[{"name":"251 Air Force General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2258","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"130505_B1","doi-asserted-by":"crossref","unstructured":"1. 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Oncocytic subtypes of adrenal cortical carcinoma: Aggressive in appearance yet more indolent in behavior? Surgery 2019; 166(4):524\u201333.","DOI":"10.1016\/j.surg.2019.05.049"},{"key":"130505_B9","doi-asserted-by":"crossref","unstructured":"9. Mete O, Erickson LA, Juhlin CC, et al. Overview of the 2022 WHO classification of adrenal cortical tumors. Endocr Pathol 2022; 33(1):155\u201396.","DOI":"10.1007\/s12022-022-09710-8"},{"key":"130505_B10","doi-asserted-by":"crossref","unstructured":"10. Rosenberg R, Raeburn CD, Clay MR, et al. Dual aldosterone- and cortisol-secreting adrenal cortical carcinoma: pre- and perioperative evaluation and management. JCEM Case Rep 2023; 1(4):luad073.","DOI":"10.1210\/jcemcr\/luad073"},{"key":"130505_B11","doi-asserted-by":"crossref","unstructured":"11. Kaur RJ, Pichurin PN, Hines JM, et al. Adrenal cortical carcinoma associated with lynch syndrome: a case report and review of literature. 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Combination chemotherapy in advanced adrenocortical carcinoma. N Engl J Med 2012; 366(23):2189\u201397.","DOI":"10.1056\/NEJMoa1200966"},{"key":"130505_B22","doi-asserted-by":"crossref","unstructured":"22. Bedrose S, Miller KC, Altameemi L, et al. Combined lenvatinib and pembrolizumab as salvage therapy in advanced adrenal cortical carcinoma. J Immunother Cancer 2020; 8(2):e001009.","DOI":"10.1136\/jitc-2020-001009"},{"key":"130505_B23","doi-asserted-by":"crossref","unstructured":"23. Wang X, Zhou N, Xiao Y, et al. Metastatic adrenal cortical carcinoma responding to octreotide: a case report. The Oncologist 2019; 24(8):e793\u20137.","DOI":"10.1634\/theoncologist.2018-0855"},{"key":"130505_B24","doi-asserted-by":"crossref","unstructured":"24. Mauda\u2010Havakuk M, Levin E, Levy EB, et al. Long\u2010term outcomes in patients with advanced adrenocortical carcinoma after image\u2010guided locoregional ablation or embolization. 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