Adrenocortical Carcinoma
Adrenocortical carcinoma is the least common malignant endocrine tumor. However, this disease second to anaplastic thyroid cancer is the most aggressive endocrine cancer. Over 30% of patients have widespread disease when they are initially seen by the physician. Early surgery with removal of the effected adrenal gland is the only means for cure. Patients may have no symptoms when they have this condition however occasionally abdominal pain may be the first sign of this disease. Patients may also have weight loss. More commonly these tumors secrete a variety of hormones including cortisol, catecholamines etc. In these cases the patient will have the clinical presentation of these excess hormone productions. The tumors are typically identified by CT or MR imaging. Once the tumor is localized most of these patients will have an open operation, however, in some instances when the tumor is small and resection safe an expert team may approach this laparoscopically. When these tumors are identified early and removed completely patients can be cured.
In some patients chemotherapy may be an option for treatment. There are several clinical trials that are being conducted to evaluate new treatments after surgery.
