Large adrenocortical adenoma with malignant features on imaging: A case report

Large adrenocortical adenomas have rarely been reported. We describe a case of a 26-year-old man who underwent an adrenalectomy for a large adrenocortical adenoma (8.6 × 7.7 cm). Although the lesion had typical malignant features on imaging, histopathological examination revealed an adrenocortical adenoma. This highlights that imaging alone may not be able to distinguish adrenocortical carcinomas from adrenal masses. In most cases, a resection should be performed for early diagnosis and management of large adrenal masses with malignant features on imaging. To our knowledge, this is the first report of a large adrenocortical adenoma diagnosed with multiple imaging investigations. •A patient presented with abdominal and left flank pain.•We observed an ≥8-cm lesion that appeared to be malignant on imaging.•Histologically, the lesion was diagnosed as an adrenocortical adenoma.•Adrenocortical adenomas with malignant imaging features must be resected.•This will allow their early diagnosis and treatment.