An 11-year-old Korean male boy was admitted to this hospital because of acute abdomen, along vomiting and shock state on January 8, 1974. Occasional abdominal pain for the past few months. About 1 month prior to admission, he- had sustained a. kick on his abdomen while playing which was followed by a considerable distress.
Cardiac arrest was recovered by cardiac massage while he was, treated for the 1emorrhagic shock. A working diagnosis of delayed´ rupture of the spleen was made by revealing abdominal cavity to be filled with blood by peritoneal puncture. On opening the abdomen, a large quantity of blood clot and hemorrhagic necrotic debris were found. This necrotic tissue debris appeared to be coming from the dark red hemorrhagic friable tumor situated in close proximity to the left kidney, retroperitoneally, measuring to be about the size of a child-head. The spleen and liver were intact.
Pathologically, this tumor was extremely friable, necrotic and poorly encapsulated, weighing 470.0 gm. This tumor was well separated from the left kidney. An intact adrenal gland was found on paraffin sections.
This retroperitoneal heterotopic adrenal cortical tumor was made up of many irregular hyperchromatic nuclei, many bizarre and multinucleated forms, along with calcifications and bone formations.
This non-functioning, adrenal cortical carcinoma is apparently arising from the heterotopic adrenal cortical tissue which lies between the adrenal glands, retroperitoneally.
He was discharged on January 31, 1974, on the 23rd hospital day, with complete recovery. Follow-up study shows that he is in an excellent shape and attending the school with full activity.
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