PMC10258337_01
Characteristics of primary adrenal cortex tumor. (A) CT scan result of the patient revealed left adrenal gland huge mass. (B) CT-3D reconstruction of patient's abdomen. (C) Surgical removal of adrenal cortex tumor. (D) Immunohistochemical results of tumor tissue.
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Computed tomography (CT) scan and ultrasound examination were preformed that day, which revealed a large mass in the left adrenal gland ( Figure 1A ). And 3D reconstruction of CT scans showed a significant soft tissue burden in the left adrenal area with the size of approximately 15.9 cm x 15.5 cm, the lesion showed a clear boundary and was supplied by the left adrenal artery and the branches of the left renal artery ( Figure 1B ). Tumor immunohistochemistry parameters were CgA (-), Melan-A (+), Syntwo (+), AE1/AE3 (+), P53 (-) ( Figure 1D ), and Ki-67 approximately 3%. The postoperative blood test results were as follows: plasma ACTH, TSTO, 24-hour UFC levels were 30.2 pg/ml, 15.0 ng/dl, and 36.55 mug/dl, respectively, returned to normal levels.
Timeline of this case.
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The timeline of the case including the most important therapeutic procedures is shown in  Figure 2 .
TACE perioperative imaging results. (A) CT scan picture of patient after the first TACE. (B) CT scan picture of patient after four TACE surgeries. (C) The abdomen conventional dynamic enhanced MRI image in March 2022. (D) The abdomen conventional dynamic enhanced MRI image in September 2022.
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TACE, a microcatheter was used to infuse a mixture of 10 ml of lipiodol and 5 ml of leroxatin through the superior mesenteric artery to the blood supply artery of the liver tumor and a good deposition effect was obtained ( Figure 3A ). The patient did not experience any side effects and continued to receive mitotane and hydrocortisone treatment. April, 18 April and 9 May, respectively. All the treatment went smoothly, and the mitotane and hydrocortisone treatment was continued during this period ( Figure 3B ).