ADRENAL GLAND - Carcinoma of the adrenal cortex

This roughly hemispherical mass measured some 10.0 cm. in maximum dimension. The cut surface shows a nodular pattern and is brownish in colour with areas of necrosis. Microscopy showed this to be a carcinoma of the adrenal cortex.
This man was admitted to hospital with a 3-month history of tiredness and loss of appetite and a marked weight loss. He described night sweats. Investigation showed proteinuria and numerous white cells in the urine; there were hyaline and granular casts present. His liver was markedly enlarged. A renal biopsy showed membranous glomerulonephritis; further investigations showed a mass in the right renal area and his abdomen was explored. A 10.0 cm. mass was felt above and separate from the superior pole of the right kidney behind the peritoneum. Some 3 weeks after discharge he was readmitted with abdominal pain. He died in hospital before investigations were complete and permission for autopsy was refused.