An Unusual Case of Acute Abdomen With Jaundice

Adrenocortical carcinomas are rare but aggressive tumors that are frequently discovered as incidentalomas. Secretory tumors often lead to endocrine abnormalities, namely cushingoid features, virilization, or feminization. Non-functioning tumors, on the other hand, can be completely dormant with an insidious course or cause malaise, weight loss, abdominal pain, etc. Biochemical testing must be pursued in all patients with incidentalomas to detect pheochromocytoma, excess cortisol, or aldosterone secretion. In this report, we describe the case of a 37-year-old man who was lost to follow-up for two years following diagnosis with adrenal incidentaloma. This led to delayed diagnosis of adrenal carcinoma and eventual mortality. Periodic surveillance of adrenal incidentalomas is therefore imperative for timely interception of malignant lesions.