title: Ectopic adrenocortical carcinoma located in the ovary.
abstract: OBJECTIVE
  Ovarian corticosteroid-producing tumors are exquisitely rare. Our aim was to describe the first case observed in our practice.
  
  
  METHODS
  A 34-year-old female was referred for Cushing's syndrome (CS) occurring in the postpartum period. Clinical examination showed severe CS with diabetes mellitus, hypertension, and a large mass in the right lower abdomen. Biochemistry demonstrated corticotropin (ACTH)-independent CS (cortisol=1900ng/mL (n=50-250), ACTH<10pg/mL (n=20-46)) with estradiol and testosterone overproduction.
  
  
  METHODS
  Abdomen CT scan revealed a 14cm right ovarian mass and small adrenal glands. Surgical exploration found the ovarian tumor with hemoperitoneum and enlarged lymph nodes. Histological study confirmed adrenocortical tumor located in the ovary with a Weiss score >5, associated with peritoneal and lymph node metastases. Immunohistochemical staining was positive for inhibin-α, melan-A, and SF1, demonstrating tissue of adrenal origin. After surgery, plasma glucose level spontaneously returned to normal. However, the patient died on the second post-surgical day due to catastrophic pulmonary embolism.
  
  
  CONCLUSIONS
  In this reported case, clinical, hormonal, histological, and immunohistochemical findings confirmed a cortisol and sex hormone-producing ovarian tumor with peritoneal and lymph node metastases, a very rare but important condition to recognize.
authors: Department and Endocrine and Metabolic DiseasesBab El Oued Teaching Hospital Algiers, Algiers, Algeria chentli.f@gmail.com.
authors: Farida
authors: F
authors: Chentli
authors: Department of PathologyPierre and Marie Curie Centre, Algiers, Algeria.
authors: Nadia
authors: N
authors: Terki
authors: Department and Endocrine and Metabolic DiseasesBab El Oued Teaching Hospital Algiers, Algiers, Algeria.
authors: Said
authors: S
authors: Azzoug
mesh_terms: D018268:Adrenocortical Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000328:Adult; D003480:Cushing Syndrome / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed