Adrenal Cortical Cancer

Adrenal cortical (or adrenocortical) cancer is cancer that forms in the outer layer of the adrenal glands. The adrenal glands are located in the abdomen and one gland sits atop each kidney. While adrenal cancer is quite rare — only about 600 new cases are diagnosed each year — and tends to be more treatable in children, it can be quite aggressive in adults, particularly if there is a recurrence.

The UC Davis Comprehensive Cancer Center provides comprehensive, multidisciplinary care for patients with all stages of adrenal cortical cancer. Our patients receive all of their care from a team of top academic physicians.

cells Some methods that may be used to diagnose adrenocortical carcinoma include:

Physical exam and history: Your specialist will check for signs of unusual lumps, and take a history of your health habits and past illnesses and treatments.

Magnetic resonance imaging (MRI): A noninvasive procedure that uses magnets and radio waves to produce images of the inside of the abdomen.

Positron emission tomography scan (PET scan): A noninvasive procedure that illustrates the body’s biological processes. The patient is injected with a small amount of radioactive sugar; since malignant tumor cells basically eat sugar more than normal cells, the malignant cells will show up more brightly in the three-dimensional picture produced by the PET scan.

Urine test: A higher than normal amount of cortisol in the urine may be indicative of disease.

Computerized Tomography (CT or CAT) scan: A procedure that photographs the inside of the body from different angles. The patient may be injected with or swallow a dye that will help the organs or tissues show up more clearly.

Blood chemistry study: A blood sample is checked for the amount of potassium, sodium or other substances released into the body; a higher or lower amount than usual can be indicative of disease.

Sources: National Cancer Institute, American Association of Endocrine Surgeons and UC Davis Comprehensive Cancer Center

Children are often diagnosed at an early stage, because their developing bodies react more strongly to the presence or absence of the hormones produced by the adrenal glands. The earlier diagnosis often results in rapid and successful treatment.

However, adults are often diagnosed at a later stage, when the cancer has or is spreading, because symptoms may simply not be as obvious. Some symptoms may include pain in the abdomen or back, a constant sensation of abdominal fullness or bloating. Adrenocortical cancers often secrete hormones that produce symptoms such as balding, facial hair growth, sweats, weight loss, weakness or easy bruising.

Sources: National Cancer Institute, American Association of Endocrine Surgeons and UC Davis Comprehensive Cancer Center

There are few risk factors for adrenal cortical cancer, apart from having the following rare hereditary diseases:

Li-Fraumeni syndrome: A predisposition to multiple cancers, caused by a mutation in a gene that normally prevents tumor growth.
Beckwith-Wiedemann syndrome: An overgrowth disorder caused by a gene mutation. Babies are large at birth, with a large tongue and internal organs, and potentially low blood sugar.
Carney complex or syndrome: A gene mutation that results in dark spots on the skin and tumors in the heart, endocrine glands, skin and nerves.

Sources: National Cancer Institute, American Association of Endocrine Surgeons and UC Davis Comprehensive Cancer Center

Surgery

Treatment of adrenocortical cancer begins with the surgical removal of the tumor and the associated adrenal gland. Nearby lymph nodes and tissues may also be removed. Surgical removal is the only treatment for the early stages of this cancer. An individual diagnosed at a later stage may also require radiation and/or chemotherapy.

More about surgical interventions for adrenal cancer

Chemotherapy

Mitotane, a drug that is a chemical relative of the pesticide DDT, has been shown to reduce the risk of tumor recurrence. For advanced or metastatic ACC, the current standard chemotherapy regimen is a combination of drugs including doxorubicin, cisplatin, etoposide and mitotane.

Sources: National Cancer Institute, American Association of Endocrine Surgeons and UC Davis Comprehensive Cancer Center