Neuroendocrine carcinoma of the adrenal gland: A rare case report and literature review

TL;DR

A rare case of neuroendocrine carcinoma in the adrenal gland is reported, highlighting the need for accurate diagnosis and combined treatment approaches.

Contribution

This paper presents a rare clinical case of adrenal neuroendocrine carcinoma with a focus on diagnostic and treatment challenges.

Findings

The patient was diagnosed with poorly differentiated neuroendocrine carcinoma after multiple biopsies.

MRI and CT imaging revealed a solid lesion and recurrent tumors in the adrenal gland.

The case emphasizes the importance of multimodal management for recurrent adrenal tumors.

Abstract

Neuroendocrine carcinoma (NEC) presence in the adrenal glands is rare. Neuroendocrine carcinoma manifests across a wide range of clinical presentations, from asymptomatic cases to those characterized by hormone overproduction or the tumor's mass effect. We report a 48-year-old male referred by a urology specialist with a chief complaint of right-sided back pain for the past 6 months accompanied by nausea, vomiting, and sharp stabbing headaches. The patient had a history of right adrenalectomy surgery. Elevated blood pressure of 150/110 mmHg, and no abnormalities found. The radiologist found a solid lesion and cyst at the lower pole of the right kidney and observed multiple recurrent tumors in the right adrenal on the MRI examination. The biopsy revealed poorly differentiated carcinoma and adrenocortical carcinoma tissue on the second biopsy 2 months later. The patient was diagnosed with neuroendocrine carcinoma; the patient underwent a biopsy guided by CT, followed by a pathological assessment (PA). The surgeon carried out the tumor removal surgery and performed an immunohistochemical (IHC) analysis. A 3-month follow-up is planned to evaluate the potential need for adjuvant chemotherapy. The case underscores the importance of accurate pathological diagnosis and multimodal management in recurrent adrenal tumors, particularly when considering NEC as a differential diagnosis.

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