What is adrenal cortical carcinoma?

Macroscopy (rare neoplasm, at any age, 2 rare inherited (Li-Fraumeni syndrome and Beckwith-Weidmann), most cases large invasive lesions efface native adrenal gland, on cut surface typically variegated poorly demarcated lesions with areas of necrosis, hemorrhage and cystic change) Microscopy (well-differentiated cells resemble adenoma, or bizzarre pleiomorphic cells almost like undifferentiated carcinoma metastasis to adrenal, invade adrenal vein, vena cava and lymphatics, regional lymph nodes and periaortic ones, distant hematogenous spread to lungs and other organs, bone metastasis unusual. Median survival 2 years, metastatic ones are more frequent than primary ones.