A case of Avascular Necrosis in a patient with Adrenocortical Carcinoma and Disseminated Metastasis.

28 years old, male patient was diagnosed with Metastatic Adrenocortical Carcinoma after extensive investigation. Patient's primary concern was only his right hip and right shoulder pain. On imaging investigations, the patient was diagnosed with Avascular Necrosis of the right hip joint. Further laboratory work-up for avascular necrosis showed Primary Hypercortisolism and eventually patient was found to have Adrenocortical Carcinoma base on CT and bone scan results, Avascular Necrosis usually presents with pain in the affected area, mostly involving shoulder, knee or hip joint. Among many of the causes of Avascular necrosis, one rare cause is hormone secreting Adreno cortical Carcinoma, a rare and a highly malignant tumour. Patients can present with Cushing's syndrome or can have atypical presentation like this patient. This patient did not have any symptoms related to malignancy such as loss of appetite and weight loss.