Aldosterone-producing adrenocortical carcinoma with unusual initial presentations: A rare disease and case report

Aldosterone-producing adrenocortical carcinoma (APAC) is extremely rare. It is not only the rarest functional adrenocortical carcinoma (ACC) but also the most infrequent cause of primary hyperaldosteronism (PH). Furthermore, if hypertension and hypokalemia present in a patient with ACC, they are more likely secondary to overproduction of glucocorticoid, rather than PH. To our knowledge, APAC has not yet been reported in Taiwan with detailed clinical manifestations. We present a patient diagnosed with APAC due to an unusual initial presentation, predominantly right-sided varicocele, treated successfully by en bloc resection, being disease-free for 10 months. Due to the rarity and unfavorable outcomes of APAC, we report the patient's clinical course, treatment, and follow-up outcomes.