A novel case of myxoid variant of adrenocortical carcinoma in a patient with multiple endocrine neoplasia type 1

Ko Harada, Miho Yasuda, Kou Hasegawa, Yuto Yamazaki, Hironobu Sasano, Fumio Otsuka

Research output: Contribution to journalComment/debate

Abstract

Adrenocortical carcinoma (ACC) is a rare malignancy arising from adrenocortical parenchymal cells. Myxoid ACC is one of the newly identified, rare, but important histological variants of ACC, characterized by the presence of abundant extracellular Alcian Blue-positive myxoid material. Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant cancer predisposition syndrome, and the incidence of ACC in MEN1 patients has been reported to be between 1.4% and 6%. Here, we report the case of a 68-year-old Japanese woman harboring the past history of MEN1 associated with insulinoma, pituitary tumor, and hyperparathyroidism. She presented to our hospital with hypertension and hypokalemia. Imaging studies revealed a right adrenal tumor, and histological examination revealed myxoid ACC. Despite surgical resection of the tumor and mitotane therapy, the patient died 6 months after the surgery. To the best of our knowledge, this is the first reported case of the myxoid variant of ACC in a patient with MEN1. The patient’s clinical course was characterized by the development of both multiple endocrine and non-endocrine neoplasm, hyperaldosteronism, and aggressive biological behavior. This case confirmed that myxoid morphology was also associated with aggressive behavior in ACC, but further studies are required to clarify the association between MEN1 and myxoid ACC.

Original languageEnglish
Pages (from-to)739-744
Number of pages6
JournalEndocrine journal
Volume66
Issue number8
DOIs
Publication statusPublished - 2019

Keywords

  • Adrenocortical carcinoma
  • Multiple endocrine neoplasia type 1
  • Myxoid variant

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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