Adrenal Incidentalomas in Cancer Patients Are Not Always “Innocent”: A Case Report and Review of the Literature

Abstract

Herein, we report an unusual case of a 78-year-old woman with synchronous presentation of sigmoid cancer and a nonfunctioning primary adrenal cortex carcinoma, who developed superior vena cava syndrome due to metastatic lymphadenopathy from the latter malignancy. Our case suggests that adrenal incidentalomas during initial staging evaluation after cancer diagnosis are not always “innocent” and should not be “a priori” considered incidental findings attributed to hyperplasia, adenoma or even a non life-threatening metastasis from the primary tumor. It also emphasizes the importance of a continuous assessment of patients with synchronous primary malignancies, in order to timely evaluate changes in clinical or biological behavior and administrate the appropriate treatment.

Triple synchronous primary malignancies: a rare occurrence

“…Synchronous colorectal and adrenocortical carcinoma has been described twice in the literature. Economopoulou et al 15 reported two case series in which patients with colon cancer underwent an adrenalectomy and one patient was found to have adrenocortical carcinoma. Karamurzin et al 16 reported a patient with Lynch syndrome, who was found to have an adrenocortical carcinoma.…”