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Adrenocortical Carcinoma: What is it?

Adrenocortical carcinoma or adrenal cortical carcinoma (ACC) is a cancer of the adrenal gland. This condition is known as cancer of the adrenal cortex and it is very rare type of cancer. This cancer can spread to other parts of the body including the liver, bones or lungs. This is an aggressive type of cancer which originates in the cortex of the adrenal gland. It is estimated that nearly 1-2 million population has been annually affected with adrenocortical cancer rare tumor.

 

Signs and Symptoms:

The symptoms of adrenocortical carcinoma may present differently in adults and children. Most of the tumors are functional in children; the common presenting symptom is virilization which is followed by precocious puberty and Cushing’s syndrome. Adults presenting hormonal syndromes show Cushing’s syndrome which is followed by mixed Cushing and virilization. Pheochromocytoma like hypersecretion of catecholamine is reported very rarely in adrenocortical cancers.

All patients who are suspected for adrenocortical carcinoma should be carefully evaluated for signs of hormonal syndrome. Some of the symptoms for Cushing’s are purple lines on the abdomen, weight gain, fragile skin and muscle wasting. Virilism is most common amongst women and it may lead to enlargement of the clitoris, acne, excess facial and body hair.

Causes:

The causes of adrenocortical carcinoma are unknown. However, this can also be a secondary cancer that happens when another form of cancer spreads to the adrenal glands.

Diagnosis:

The diagnosis includes laboratory findings, pathology and radiology.

  1. Laboratory Findings: The hormonal syndrome can be confirmed with laboratory testing. The findings in Cushing syndrome show an increase in urine cortisol and serum glucose in the blood sugar. Adrenal Virilism is confirmed with the excess of androstenedione and dehydroepiandrosterone.

 

  1. Pathology: The cell block preparation from a fine-needle aspiration biopsy of a large ACC shows tumor cells. These cells are compact, have a mild degree of nuclear pleomorphism and eosinophilic cytoplasm. The adrenal tumors are not biopsied before surgery and so diagnosis will confirm after examining the surgical specimen by a pathologist. 

 

  1. Radiology: The radiological studies of the abdomen involve magnetic resonance imaging and CT scans for identifying the actual site of tumor, determining its extent of invasion to the surrounding tissues and organs. This also helps differentiating this condition from other diseases. These studies are critical for determining if or not the tumor can be removed surgically.

 

Other diagnosis for adrenocortical adenoma includes renal cell carcinoma, adrenocortical adenoma, hepatocellular carcinoma and adrenal medullary tumors.

Treatments:

The only curative treatment for adrenocortical carcinoma is complete surgical excision of the tumor. This is usually performed in case of the tumor invasion into the large blood vessels like inferior vena cava or the renal vein. After completion of successful surgery, the five year survival rate for the patient in 50-60%. But a large percentage of patients are not surgical candidates. So the radiofrequency ablation and the radiation therapy is used for patients who are not surgical candidates.

Chemotherapy including drug mitotane is inhibited of the steroid synthesis that is toxic for the cells of the adrenal cortex. Retrospective analysis has showed the survival benefit for mitotane along as an addition to surgery as compared to the surgery alone. The most common chemotherapy regimen includes doxorubicin, cisplatin, streptozotocin + mitotane and etoposide + mitotane.

 

Why choose India for treating Adrenocortical Carcinoma?

India is a fast growing medical treatment hub which offers better medical services and care for international patients at lower prices. Patients suffering from adrenal carcinomas often choose India for undergoing the complete surgical resection. India Cancer Surgery Site is a medical tourism company in India that offers quality medical care for patients with adrenocortical carcinoma. They ensure to provide you best medical facilities, highly skilled surgeons for treating your medical condition.

It is suggested that you should talk with your doctor regarding your concerns for undergoing treatment in India. This will help you clear every detail of your medical condition and what treatment is appropriate for your condition.

References:

Savarese, Diane MF; Lynnette K Nieman (2006-08-08). "Clinical presentation and evaluation of adrenocortical tumors". UpToDate Online v. 15.1. UpToDate. Retrieved 2007-06-05.

Savarese, Diane MF; Lynnette K Nieman (2006-08-08). "Clinical presentation and evaluation of adrenocortical tumors". UpToDate Online v. 15.1. UpToDate. Retrieved 2007-06-05.

Allolio B, Fassnacht M (2006). "Clinical review: Adrenocortical carcinoma: clinical update". J Clin Endocrinol Metab 91 (6): 2027–37.

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