Synchronous adrenal cortical carcinoma in a patient with lung cancer.

Workup of a patient with lung cancer involves adrenal imaging for evaluation of metastatic disease. When nodules are detected, biopsy is often attempted to differentiate a primary neoplasm from metastatic carcinoma or other lesions, such as granuloma. CT-guided biopsy of the deep seated adrenal glands is technically difficult and material is often scanty. We present a case and review histologic features enabling the diagnosis of adrenal cortical carcinoma.