Rapidly Progressive Metastatic Adrenocortical Carcinoma With Oncocytic Features in a Young Male: A Case Report

Adrenocortical carcinoma (ACC) is a rare but highly aggressive endocrine malignancy, often diagnosed at an advanced stage with limited treatment options and a poor prognosis. We present the case of a 29-year-old male who presented with pleuritic chest pain and was found to have a large right abdominal mass with widespread metastatic disease. Histological analysis revealed ACC with oncocytic features, a rare and distinct variant of ACC. Despite prompt diagnostic work-up and supportive care, the patient deteriorated rapidly. This case underscores the diagnostic challenges and dire prognosis associated with ACC and highlights the importance of early detection, multidisciplinary evaluation, and genetic testing with or without family history.