Pitfalls in the diagnostics of aldosterone-producing adrenocortical carcinoma.

We present the case of a male patient with primary aldosteronism. Abdominal computed tomography showed the lesion in the right adrenal that was firstly recognized as lipid-poor adenoma according to misleading radiological description. The patient was operated on - for hormonal, not oncological reasons - yet as late as a year after the first CT. Histopathology revealed the diagnosis of aldosterone-producing adrenocortical carcinoma, which is a very rare malignancy. Fortunately and unlikely for adrenocortical carcinomas (ACC), the course of the disease was favorable for the patient and he is in remission after the operation. However, ACC usually has poor prognosis, so our case shows how the pitfalls in managing this patient with malignant adrenal tumour could have been avoided.