Adrenocorticaal carcinoom als uiterst zeldzame oorzaak van psychose, hypokaliëmie en metabole alkalose

Adrenocortical carcinoma: an extremely rare cause of psychosis, hypokalemia and metabolic alkalosis Adrenocortical carcinoma (ACC) is an utmost rare malignancy with a generally poor prognosis due to the fact that most ACCs are diagnosed in a late stage. The case of a 40-year-old female patient diagnosed with liver-metastasized ACC after an acute psychotic episode in the presence of severe hypokalemia and metabolic alkalosis is presented. Despite the treatment with ketoconazole followed by an adrenalectomy and adjuvant therapy with mitotane, the patient showed rapid clinical deterioration. Palliative care was initiated about a month after her admission. She died a few weeks later. This article summarizes the current literature on the epidemiology, clinical presentation, diagnosis, treatment and prognosis of ACC.