Adrenocortical Carcinoma Presenting with Vaginal Metastasis
Abstract
Adrenocortical carcinoma is an aggressive malignancy which is metastatic at the time of presentation in over one third of the cases. Common sites of metastasis are lung, liver, peritoneum, skin, bone, brain and rarely heart. Only one case of vaginal metastasis from adrenocortical carcinoma is reported in literature. We are reporting a rare functioning metastatic adrenocortical carcinoma with vaginal deposit.
A 29 year old lady presented with menorrhagia, hypertension, and hirsuitism. She was found to have right sided abdominal mass and endocrinological evaluation showed functioning tumour. CT scan revealed adrenal tumour with hepatic and pulmonary metastasis.Clinical examination revealed an anterior vaginal wall nodule apart from previous findings. Biopsy of the same was metastatic disease from adrenocortical carcinoma. She was treated with chemotherapy using cisplatin and etoposide and expired two months later with progressive disease.
Clinical examination for metastatic disease may yield easily accessible site for biopsy. Per vaginal examination may be done for patients with metastatic adrenocortical carcinoma to exclude presence of metastatic disease and may be an easy site for biopsy.
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