Adrenal cancer

Adrenal Cancer

Adrenal cancer, also known as adrenocortical carcinoma, is a rare and aggressive form of cancer that originates in the cortex of the adrenal gland. The adrenal glands are small, triangular-shaped glands located on top of each kidney. They are responsible for producing hormones such as cortisol, aldosterone, and adrenaline, which are crucial for various bodily functions.

Epidemiology

Adrenal cancer is an uncommon malignancy, with an incidence of approximately 1 to 2 cases per million people annually. It can occur at any age but is most commonly diagnosed in adults between the ages of 40 and 50. There is a slight female predominance in the occurrence of adrenal cancer.

Pathophysiology

The adrenal cortex is divided into three zones: the zona glomerulosa, zona fasciculata, and zona reticularis. Adrenal cancer can arise from any of these zones, leading to overproduction of hormones. This overproduction can result in clinical syndromes such as Cushing's syndrome, hyperaldosteronism, or virilization, depending on the hormones involved.

Clinical Presentation

Patients with adrenal cancer may present with a variety of symptoms, often related to hormone excess. Common symptoms include:

• Weight gain, particularly in the face and trunk
• Hypertension
• Muscle weakness
• Diabetes mellitus
• Hirsutism and virilization in women
• Abdominal pain or a palpable mass

Diagnosis

The diagnosis of adrenal cancer involves a combination of imaging studies, laboratory tests, and histopathological examination.

Imaging

• CT Scan: A computed tomography (CT) scan of the abdomen can help identify the size and characteristics of the adrenal mass.
• MRI: Magnetic resonance imaging (MRI) provides detailed images of the adrenal glands and can help differentiate benign from malignant lesions.

Laboratory Tests

• Hormonal Assays: Blood and urine tests to measure hormone levels can help determine if the tumor is functional.
• Biopsy: A biopsy may be performed to obtain a tissue sample for histological examination.

Treatment

The primary treatment for adrenal cancer is surgical resection. Complete removal of the tumor, known as adrenalectomy, is the most effective treatment. In cases where the cancer has spread, additional treatments may include:

• Mitotane: A drug that suppresses adrenal cortex function and has cytotoxic effects on adrenal cancer cells.
• Chemotherapy: Used in advanced cases to help control the spread of the disease.
• Radiation Therapy: May be used postoperatively or for palliation.

Prognosis

The prognosis for adrenal cancer depends on the stage at diagnosis and the success of surgical resection. Early-stage tumors that are completely resected have a better prognosis, while advanced-stage disease has a poorer outcome.

Also see

• Adrenal gland
• Cushing's syndrome
• Endocrine system
• Oncology

Classification
External resources