Primary non-functional extra-adrenal adrenocortical carcinoma.

We present the case of a 52-year-old Jordanian man who was admitted to hospital due to a left sided abdominal mass that was discovered during a routine physical examination. The huge abdominal tumor was initially suspected to be a retroperitoneal sarcoma based on the ultrasound and computed tomography findings. Cytological analysis of the fine needle aspiration smears was unable to define the origin of this mass, and suggested a sarcoma. During laparotomy, the mass was found not connected to the adrenal gland. Only histopathological and immunohistochemical examination of the surgical specimen allowed the diagnosis of adrenocortical carcinoma. This tumor most likely has risen from an extra-adrenal rest. From a review of the medical literature, this case appears to be unique as the first well documented histologically and immunohistochemically reported case of extra-adrenal adrenocortical carcinoma.