Favourable prognosis in metastatic adrenal carcinoma: an unexpected outcome Authors Imran Hassan Department of Family Medicine, Aga Khan University Hospital, Karachi, Pakistan Aisha Sheikh Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan DOI: https://doi.org/10.47391/JPMA.3494 Abstract The case of a 45-year-old male patient diagnosed with European Network for the Study of Adrenal Tumours (ENSAT) criteria, stage IV adrenocortical carcinoma (ACC) with unexpectedly prolonged survival is being reported. The patient underwent resection of stage IV ACC and despite suboptimal adherence to postoperative mitotane and chemotherapy, had a prolonged survival spanning almost seven years. The possible reasons for such an outcome are discussed. ACC is a rare tumour with stage 4 disease known to be associated with a particularly grim prognosis. A low grade on histology (mitotic index 11-12 per 50 HPF) was likely responsible for the prolonged survival of our patient. Low grade disease may predict extended survival in stage IV ACC. Keywords: adrenal cancers, adrenal cortex diseases, adrenal gland diseases, adrenal gland neoplasms. Author Biographies Imran Hassan, Department of Family Medicine, Aga Khan University Hospital, Karachi, Pakistan Instructor Aisha Sheikh, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan Lecturer Downloads Full Text Article Published 2022-09-15 How to Cite Imran Hassan, & Aisha Sheikh. (2022). Favourable prognosis in metastatic adrenal carcinoma: an unexpected outcome. Journal of the Pakistan Medical Association, 72(10), 2101–2104. https://doi.org/10.47391/JPMA.3494 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 72 No. 10 (2022): OCTOBER Section CASE REPORT