Materials and Methods. The article describes the results of the examination of 76 patients with adrenocortical cancer (ACC), who have undergone surgery in the in-patient facility of the N.I. Pirogov Clinic of High Medical Technologies of St. Petersburg State University. ACC was diagnosed from 2009 to 2020. Patient demographic data, baseline disease characteristics, tumor hormonal activity, and computed tomography (CT) data were described. Results. Overall, the data obtained were consistent with the international literature with respect to age at onset of the disease (median age 45 years), the ratio of females to males (3:1), and the incidence of hypercortisolism (48.8 %). It was found that the combination of radiographic density < 20 HU and mass size less than 4 cm does not exclude all cases of ACC. According to the findings 2 (3.3 %) of 65 patients would not be diagnosed if the above criteria had been used. Within the CT data analysis, about one-third of patients showed no increase in the standard thresholds for absolute and relative percentage washout (RPW) that defines malignancy. The results analysis revealed that the subgroup of patients with Cushing syndrome had a statistically significant increase in contrast washout rates. Conclusion. Overall, the findings in ACC patients in the studied population are consistent with the literature data. The study results suggest that the diagnostic value of contrast washout parameters for differential diagnosis of ACC is limited, especially in patients with small tumors and with Cushing syndrome. According to the data obtained, the most reliable criterion for excluding ACR is native tumor radiodensity < 10 HU; the use of this criterion made it possible to exclude all cases of ACC.