Adrenocortical carcinoma is a type of cancer that affects the adrenal gland. The illness is also known as adrenal cortex cancer, adrenal cortical cancer, or adrenocortical carcinoma. This cancer is extremely rare.
The adrenal gland is a tiny organ that sits just above the kidney. It produces vital hormones. The body contains two adrenal glands. Each kidney has one on top of it. The endocrine system includes the adrenal glands. Your endocrine system aids in the regulation of bodily functions.
Adrenocortical carcinoma is a cancer that grows on the outer layer of the adrenal gland and spreads throughout the body. The cortex is the name given to this layer. It generates hormones that
assist in maintaining blood pressure
Balance of Water and salt in the body
aid in the management of the body's usage of protein, fat, and carbs,
contribute to a person's male or female features.Adrenocortical cancer has the potential to spread to other regions of the body, such as the lungs, liver, or bones.
Adrenal gland lumps are not uncommon. Adrenal adenomas are typically benign (noncancerous) growths. In rare circumstances, doctors may have difficulty distinguishing between an adenoma and cancer, therefore you may require additional tests or examinations.
A pheochromocytoma is a form of adrenal gland tumor that can develop in the inner section of the gland, known as the adrenal medulla. However, this article will solely cover malignancies of the adrenal cortex.
Symptoms of Adrenocortical Carcinoma
Adrenal gland tumors are characterized as either functioning or nonfunctioning:
Certain hormones are overproduced by a functional adrenocortical tumor. It may cause symptoms.
Hormones are not secreted by a nonfunctioning adrenocortical tumor. It may not cause symptoms right away.
The symptoms of functional adrenocortical tumors differ. They vary according to whatever hormones are overproduced and the patient's age.
Cortisol facilitates the body's utilization of sugar, protein, and fat. Excessive amounts of this hormone may cause
abdominal, face, neck, and chest fat growth
Hair growth that is profuse on the face, chest, back, or arms
stretch marks on the stomach that are purple or pink
behind the neck and shoulders is a lump of fat.
enlargement of the sexual organs or breasts (in men and women)
menstruation cycles that are irregular (in women)
extreme fatigue and muscle weakness
bone fractures prone to bruising
moodiness and/or depression
hyperglycemia (High sugar level)
hypertension (High blood pressure)
Several of these symptoms are also found in people who have Cushing syndrome. This noncancerous illness affects the brain's pituitary gland.
Aldosterone aids in the regulation of the kidney's water and salt balance. Excessive levels of this hormone may result in
muscular twitching or cramping
accumulation of fluid in the body's tissues
Androgens and estrogens are hormones that aid in the development and maintenance of male and female sex characteristics. Testosterone is the major androgen. Women who have an excess of testosterone may have
facial and body hair growth
menstrual cycle fluctuations.
Women who have an abnormally high level of estrogen may suffer
menstruation cycles that are irregular
bleeding during menstruation (if they have stopped having periods).
Men who have an excess of estrogen may have
breast development and tenderness
reduced sex drive
the difficulty of obtaining or maintaining an erection.
Children exhibit distinct symptoms. Excess hair on the face, pelvic area, and underarms can be caused by an adrenal tumor that releases male sex hormones.
a penis enlargement (in boys)
a clitoris that has been expanded (in girls).
In children, a tumor that secretes female sex hormones can trigger
early adolescence (in girls)
Enlargement of the breast (in boys).
Certain people develop symptoms when the tumor grows and presses against nearby organs and tissues. This may manifest as a lump or pain near the tumor, belly fullness, or difficulty eating or losing weight.
If you or your child exhibits any of these symptoms, consult your physician immediately.
Diagnosis of Adrenocortical Carcinoma
Typically, the initial step in diagnosis is a physical examination and medical history. Your physician will examine you for symptoms of the disease. He or she will want to know if there is a family history of adrenal cancer in your family. You will be questioned about your sexual ability and menstrual cycle (if you are female).
Numerous tests and techniques may be used to aid in the diagnosis of adrenocortical cancer. They differ according to the individual's symptoms. You may be subjected to one or more of the following examinations:
Blood and urine tests: Your blood and urine are tested to determine if there are any abnormal hormone or substance levels.
Numerous imaging tests are available to detect adrenocortical cancer. Additionally, they can assist in determining if cancer has migrated to other places of the body.
Adrenal angiography and venography: These tests visualize the arteries and veins near the adrenal gland, as well as the blood flow.
Biopsy: A needle is used to extract a sample of tumor tissue for laboratory examination. The results may reveal the origin of an adrenal gland tumor. Additionally, a biopsy can determine whether the malignancy has spread.
If you are diagnosed with adrenocortical carcinoma, your care team will need to determine if the cancer cells have spread within or outside the adrenal gland. This is referred to as staging. Staging is critical for treatment planning and determining your prognosis. Numerous tests used for diagnosis also assist physicians in determining the stage of the malignancy.
The four phases of adrenocortical carcinoma are determined by the tumor's size and extent of spread:
Stage I: The tumor is no more than 5 cm in diameter and is contained within the adrenal gland.
Stage II: The tumor exceeds 5 cm in diameter and is found exclusively in the adrenal gland.
Stage III: The tumor may be any size and may have metastasized to nearby tissues or lymph nodes.
Stage IV: The tumor has grown to any size and spread to surrounding or distant sites.
Cancer that returns after treatment is referred to as recurrent adrenocortical carcinoma.
The early stages of adrenocortical cancer are difficult to detect. As a result, when the tumor is diagnosed, it is sometimes rather large. Children are more likely to be diagnosed with the disorder because they exhibit indicators of increased hormone production earlier than adults.
Even when adrenocortical cancer is totally removed during surgery, it frequently recurs or spreads to other areas of the body.
Most adrenal gland cancers are unrelated to family history. However, some are associated with genetic defects. There is currently no known method of preventing the disease from occurring.
Treatment of Adrenocortical Carcinoma
Surgery is the preferred treatment option for the majority of adrenocortical carcinomas. Your treatment, however, will be determined by your overall health and cancer stage.
Stages I and II: Generally, these tumors are treated by removing the affected adrenal gland. If nearby lymph nodes are enlarged, they may be removed for examination. Additional treatment may not be necessary if the tumor does not produce hormones. However, follow-up examinations are advised.
Stage III: Surgical resection of adrenocortical carcinoma is the conventional treatment for stage III adrenocortical carcinoma. The purpose of this procedure is to remove the damaged adrenal gland. Nearby swollen lymph nodes are also removed. Organs nearby may also be removed. Patients diagnosed with stage III adrenocortical carcinoma are at increased risk of recurrence.
Stage IV: Cancer has frequently spread and is unlikely to be treated. Nonetheless, surgery to remove as much of the tumor as feasible may be recommended. This can help to alleviate symptoms and improve a person's quality of life. Additionally, radiation therapy and chemotherapy may aid in the management of symptoms.
Recurrent adrenocortical cancer: This is typically treated as stage IV disease, however, the therapy is determined by a number of variables. These include the patient's adrenocortical cancer history and the location of the recurrence.
In the case of stage III and IV adrenocortical cancer, as well as recurring adrenocortical cancer, a medication known as mitotane is frequently used, either with or without further chemotherapy. Mitotane aids in the slowing of cancer growth and may alleviate symptoms associated with excessive hormone production.
Care will be focused on reducing pain and promoting well-being when medicines are no longer effective.
When Should You Talk to A doctor?
Consult with your doctor if you or your child exhibits any of the following signs of adrenocortical carcinoma:
menstruation cycles that are irregular
early puberty sexual behavior that is irregular (in children).
Prognosis of Adrenocortical Carcinoma
The prognosis for patients with adrenocortical cancer is determined by a number of factors. These include the following:
the disease's stage
whether the tumor can be entirely removed during surgery
how rapidly cancer grows
whether the cancer was previously treated
the general health of the patient.
Patients diagnosed with cancer in the early stages have a decent chance of survival. Many can be cured with surgery. However, only a small percentage of persons are diagnosed with stage I adrenocortical cancer. People with advanced disease have a worse prognosis.
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Additional Information can be reached at
https://www.cancer.gov/ National Cancer Institute (NCI)
The American Cancer Society (ACS) https://www.cancer.org/.