Endocrine Abstracts

Introduction: Malignant adrenal tumors are primarily represented by adrenocortical carcinoma and malignant pheochromocytomas. These tumors are rare but potentially aggressive, carrying a bleak prognosis. The aim of this study is to report the clinical, laboratory, and evolutionary characteristics of malignant adrenal tumors.

Patients and Methods: A retrospective descriptive study was conducted at the Endocrinology Department over a 12-year period from 2010 to 2022, including all patients presenting with a malignant adrenal tumor at Ibn Rochd University Hospital in Casablanca. Data analysis was performed using Microsoft Excel 2017.

Results: The study comprised 16 patients, including 9 men and 7 women, with an average age of 42 years. None of the patients had a family history of malignant tumors. There were 12 cases of malignant pheochromocytomas, 3 cases of adrenocortical carcinoma, and 1 case of ganglioneuroblastoma. Discovery circumstances included hypertension in 7 cases, Menard’s triad in 3 cases, Cushing’s syndrome in 2 cases, abdominal pain in 3 cases, general malaise in 2 cases, and follow-up post-adrenalectomy in 2 cases. The average tumor size was 6.8 cm, with bilateral involvement in 2 patients. Adrenalectomy was performed in 13 patients, while 3 others had a contraindication to surgery. Metastases were identified in the liver, lungs, bones, lymph nodes, and stomach. There were 2 cases of recurrence and 1 case of death. Eleven patients were referred to oncology.

Conclusions: The diagnosis of malignancy can be challenging in the absence of metastases. Regional evaluation of the tumor and the presence or absence of metastasis are necessary to establish prognosis and guide treatment decisions. Therapeutic decisions are made in multidisciplinary consultation.