Case ReportsPrimary Adrenocortical Carcinoma With Skull Metastasis: Case Report and Review of the LiteratureBose, Bikash MD, FACS, FICS, FAHA*,†Author Information *Department of Neurosurgery, Christiana Care Health System, Newark, DE †Department of Neurosurgery, Jefferson Medical College, Philadelphia, PA No outside financial or material support. Reprints: Bikash Bose, MD, FACS, FICS, FAHA, C-79 Omega Drive, Newark, DE 19713 (e-mail: email@example.com). Neurosurgery Quarterly: February 2011 - Volume 21 - Issue 1 - p 63-68 doi: 10.1097/WNQ.0b013e3182086ae0 Buy Metrics Abstract Adrenocortical carcinoma (ACC) is a rare but highly aggressive neoplasm. It is not often diagnosed early. At diagnosis, up to 70% of patients have disease that extends beyond the adrenal glands. Although regional disease and/or metastases to the peritoneum, liver, lung, or bone are common, metastasis to the skull is extremely rare. The author believes this to be only the third case reported in the literature. Despite advances in cancer therapy over several decades, prognoses for patients with ACC remain grim. Radical surgical excision is the only approach that may cure localized disease. Thus far, radiation therapy and chemotherapy have shown little impact on the course of ACC. © 2011 Lippincott Williams & Wilkins, Inc.