title: Adrenocortical carcinoma presenting as bilateral pitting leg oedema.
abstract: We report a case of a 54-year-old woman presented with bilateral pitting leg oedema. Initial workup for common aetiologies was unrevealing and diuretic therapy was ineffective. A CT scan of the abdomen demonstrated left adrenal mass with direct invasion of the adrenal vein and inferior vena cava with direct extension to the right atrium. Adrenocortical carcinoma was confirmed in biopsy and the patient was operated within several days. Fifteen months postoperation, the patient is doing well with good performance status and still in oncological treatment and follow-up. When the common causes of bilateral oedema have been ruled out, no delay should be experienced seeking abdominal mass with vascular invasion potential, as early diagnosis and treatment may be lifesaving.
authors.affiliation: Internal Medicine H and B. Shine Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Mohammad Ebrahim
authors.initials: ME
authors.lastname: Naffaa
authors.forename: Anat
authors.initials: A
authors.lastname: Ilivitzki
authors.forename: Eyal
authors.initials: E
authors.lastname: Braun
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000175:diagnosis*; D018268:Adrenocortical Carcinoma / Q000150:complications / Q000175:diagnosis*; D004487:Edema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007866:Leg; D008875:Middle Aged; D014057:Tomography, X-Ray Computed