New Diagnosis of Adrenocortical Carcinoma with Stroke Workup

Authors

Ruoyan Zhu, Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center Phoenix, Phoenix, AZ, USA.
Tshibambe Nathanael Tshimbombu, Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center Phoenix, Phoenix, AZ, USA.
Monica C. Rodriguez, Barrow Pituitary Center and Neuroendocrinology Clinic, Barrow Neurological Institute, University of Arizona College of Medicine and Creighton University School of Medicine, Phoenix, AZ, USA.
Mercedes Martinez Gil, Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE, USA.
Kevin C. Yuen, Barrow Pituitary Center and Neuroendocrinology Clinic, Barrow Neurological Institute, University of Arizona College of Medicine and Creighton University School of Medicine, Phoenix, AZ, USA.
Paige Banyas, Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center Phoenix, Phoenix, AZ, USA.

Document Type

Article

Abstract

INTRODUCTION: Ischemic stroke has well-established risk factors such as hypertension, diabetes, hyperlipidemia, and atrial fibrillation. However, strokes can also occur in the context of less common etiologies such as malignancies, particularly as certain malignancies are associated with hypercoagulable states. Adrenocortical carcinoma (ACC) is a malignancy that can present with a hypercortisolemic state, which can further exacerbate cancer coagulopathy and the traditional metabolic risk factors of stroke. CASE PRESENTATION: A 60-year-old woman presented with expressive aphasia and was found to have multifocal acute infarcts on magnetic resonance imaging. She underwent a thorough cardiac, coagulopathy, and paraneoplastic workup and was found to have a right adrenal mass and was biochemically hypercortisolemic. The patient underwent surgical resection of the adrenal mass and pathology confirmed the diagnosis of ACC. CONCLUSION: The discovery of this rare malignancy underscores the complex interplay between malignancy, hormonal imbalances, hypercoagulability in stroke and the importance of a comprehensive clinical diagnostic evaluation.

Publication Date

1-1-2025

Publication Title

Case reports in neurology

ISSN

1662-680X

Volume

17

Issue

1

First Page

204

Last Page

210

PubMed ID

41415212

Digital Object Identifier (DOI)

10.1159/000549473

Recommended Citation

Zhu, Ruoyan; Tshimbombu, Tshibambe Nathanael; Rodriguez, Monica C.; Martinez Gil, Mercedes; Yuen, Kevin C.; and Banyas, Paige, "New Diagnosis of Adrenocortical Carcinoma with Stroke Workup" (2025). Neurology. 2039.
https://scholar.barrowneuro.org/neurology/2039