title: Development of ipsilateral adrenocortical carcinoma sixteen years after resection of an adrenal tumour causing Cushing's syndrome.
abstract: BACKGROUND
  At times, it may be difficult to differentiate early stage, low-grade adrenocortical carcinoma from benign adrenal adenoma.
  
  
  METHODS
  A 53-year-old lady underwent right adrenalectomy for a 4-cm adrenocortical tumour causing Cushing's syndrome. Histology revealed an adrenocortical adenoma. Sixteen years later, she presented with a 14-cm adrenal tumour, again on the right side.
  
  
  METHODS
  She underwent surgical removal of the tumour. Histology confirmed adrenocortical carcinoma.
  
  
  RESULTS
  She died of metastatic disease 17 months later.
  
  
  CONCLUSIONS
  This case highlights the importance of long-term, systematic follow-up of patients treated for benign adrenal adenomas, especially if the tumour size exceeds 4 cm.
authors.affiliation: Department of Medicine, National University Hospital, Singapore.
authors.forename: H S
authors.initials: HS
authors.lastname: Tan
authors.forename: A C
authors.initials: AC
authors.lastname: Thai
authors.forename: M E
authors.initials: ME
authors.lastname: Nga
authors.forename: J J
authors.initials: JJ
authors.lastname: Mukherjee
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D018246:Adrenocortical Adenoma / Q000473:pathology; D018268:Adrenocortical Carcinoma / Q000150:complications / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D003480:Cushing Syndrome / Q000209:etiology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*