Adrenal Cortex Carcinoma

Etomidate administration led to marked suppression of cortisol and aldosterone, while 11-deoxycorticosterone levels increased substantially. Interestingly, despite the elevated 11-deoxycorticosterone, serum potassium normalized, highlighting a complex interplay among mineralocorticoid precursors and active hormones in maintaining electrolyte balance.

The patient completed six cycles of adjuvant chemotherapy with tegafur-gimeracil-oteracil (S-1) plus oxaliplatin, and routine follow-up examinations showed no evidence of recurrence...The patient was treated with SOX chemotherapy combined with the PD-1 inhibitor tislelizumab...This case highlights the importance of vigilance for rare metastatic sites, such as the adrenal gland, in patients with advanced gastric cancer even after standardized postoperative surveillance. Systemic chemotherapy combined with immunotherapy may represent an effective treatment strategy for selected patients with metastatic gastric cancer.

Despite multiple adverse prognostic indicators, the patient has remained disease-free for over 5 years following adrenalectomy and adjuvant low-dose mitotane therapy. These findings suggest that GNAS activation may drive steroidogenesis while attenuating malignant progression, as demonstrated by integrated morphologic and genomic assessment in this case.

PRKD3 expression also correlated with immune checkpoint molecules including PD-1, PD-L1, and CTLA-4, supporting an immunosuppressive role, while context-dependent associations with TMB and MSI highlighted its potential influence on tumor immunogenicity and responsiveness to immune checkpoint blockade. Collectively, these findings identify PRKD3 as a potential context-dependent modulator of tumor biology, prognosis, and immune interactions, underscoring its potential as a biomarker of diagnostic, prognostic, and therapeutic relevance in precision oncology.

Genetic testing identified a pathogenic VHL mutation: NM_000551.4(VHL):c.508G>A, consistent with VHL type 2C phenotype. Systematic screening for other VHL-associated lesions was negative. This case highlights the diagnostic challenge posed by clinically silent pheochromocytomas and underscores the importance of genetic evaluation in atypical adrenal tumors.

Further optimization is required to improve their long-term proliferation and differentiation potential. Together, these findings provide a proof-of-concept for the development of patient-derived PCC organoid models, which may ultimately serve as a platform for studying PCC biology and for future exploration of personalized therapeutic approaches.

Our findings underscore the clinical utility of this combined approach, particularly its high efficiency in the paediatric population where it identified a de novo case missed by classical criteria. However, its utility in unselected adults appears limited without orthogonal assays to exclude CHIP, suggesting that age-specific strategies are necessary for opportunistic screening.

The age range distribution is diverse and estimation of malignant potential using Lin-Weiss Bisceglia scoring criteria of OACC is of paramount importance. Beta-catenin can be applied as a useful marker for prognostication of OACCs. Insulin growth factor-2 overexpression of conventional adrenocortical carcinomas must not be extrapolated to the oncocytic variant.

P2, N=137, Active, not recruiting, Canadian Cancer Trials Group | Trial completion date: Dec 2025 --> Jun 2026

Cortisol secretion was not suppressed following a 1-mg dexamethasone suppression test, and computed tomography revealed a left adrenal tumor...A histopathological examination confirmed adrenocortical adenoma. This case demonstrates that mild autonomous cortisol secretion can impair GH secretion and cause central hypothyroidism even in the absence of any overt cushingoid features.

We observed BHDS, confirmed by a pathogenic FLCN variant in 0.7% of all ACC patients, or 1.5% of patients evaluated by a genetic counselor and 2.0% of all patients who underwent genetic testing. Testing for FLCN pathogenic variants should be considered during routine genetic evaluation of patients with ACC and special attention should be paid to adrenal tumors in BHDS patients during surveillance for renal neoplasms as more than 50% of patients in this series developed metastatic disease.

P=N/A, N=32, Not yet recruiting, University of Arizona