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Case Reports

Abstract

Adrenocortical carcinoma is a rare oncologic condition with poor prognosis that usually metastasize to the lungs, liver, local lymph nodes and peritoneum. However, skin metastases are very uncommon. The authors present a case of a 41-years-old man with known history of malignant neoplasm of cortex of right adrenal gland that presented with a painful left proximal arm mass. The histologic sections showed a multinodular lesion composed of atypical epithelioid cells with ample granular cytoplasm and pleomorphic vesicular nuclei. In addition, many atypical mitoses were noted and tumor necrosis was seen throughout the tumor. The immunohistochemical staining showed tumor cells that were strongly positive for synaptophysin and inhibin, only focally positive for Melan-A and negative for AE1/AE3. Given the clinical setting, histologic pattern and immunohistochemical profile, the diagnosis of metastatic carcinoma consistent with adrenal cortical origin was rendered.