Adrenal cortical cancer, also known as adrenocortical cancer or adrenal cortex cancer, is a malignant mass of cells that develop in the adrenal glands, located right above the kidneys. When functioning properly, the adrenal cortex processes cholesterol and secretes steroid hormones like testosterone and cortisol. It is very rare form of the disease, with less than 500 cases diagnosed per year.
Adrenal Cortical Cancer Signs & Symptoms
Adrenal cortical cancer rarely shows any symptoms, making diagnosis and treatment difficult. Patients can carry this disease for a long period of time before it is diagnosed.
However, in some cases, patients have had the following symptoms:
- Abdominal mass
- Feeling of always being full
- Weight loss
- Pain in the abdomen
Adrenal cortical cancer is usually diagnosed by one of four types of x-ray tests:
- Ultrasound: Although the quickest and most easily accessible scan, ultrasounds are also the most inaccurate, so they are used less frequently than other scans. They can, however, detect any type of adrenal tumor.
- CT (or CAT) scan: This is one of the most accurate types of scans and is used frequently in the detection and diagnosis of adrenal tumors. The scan takes photos of the affected area. The procedure, which lasts approximately 30 minutes, is painless.
- MRI scan: An MRI works much the same way as the CT scan, although an MRI uses magnetic imaging to take pictures of the body’s internal organs. The procedure takes about an hour to complete and can be used to detect any type of adrenal tumor. MRI results are normally very accurate.
- MIBG scan: Thisscan is only used to detectphenochromocytomas (tumors that produce excess adrenaline) in the adrenal glands; it does not detect any other type of mass.
Adrenal Cortical Cancer Staging
Two categories of staging are used to determine how far the mass has spread: TNM and ENSAT (developed by the American Joint Committee on Cancer, or AJCC). The two are different in how they combine categories to determine a final stage. The TNM staging categories are:
- T: Determines the size of the primary mass and whether it has spread
- N: Determines how much the cancer has spread to lymph nodes.
- M: Determines whether the cancer has spread to the body’s other organs
Sometimes the numbers 1-4 are used with the letter to indicate theseverity of the disease.
The staging in the AJCC system is:
- Stage I: The mass is less than 5 centimeters and has not spread to other areas of the body.
- Stage II: The mass is larger than 5 centimeters but has not spread to other areas of the body.
- Stage III: The mass is any size but has not spread beyond the adrenal gland, or the cancer has spread to the fat around the adrenal glands but not to the nearby lymph nodes.
- Stage IV: The mass has moved to the fat in the adrenal gland and the lymph nodes, but not to any other areas of the body; the mass has spread from the adrenal glands to other nearby organs or tissues, possibly the lymph nodes, but not to other areas of the body, or the mass has moved to other organs or tissues, is any size, and may or may not have spread to the nearby organs or lymph nodes.
Adrenal Cortical Cancer Treatment
Surgery has proven to be the most successful course of treatment for this type of cancer. Chemotherapy has shown to be very ineffective in the treatment of adrenal cortical cancer.
Adrenal Cortical Cancer Outlook
Adrenal cortical cancer generally has a poor prognosis, but this largely depends on the patient’s age and the stage of the illness. Most patients with a stage III condition have a 5-year survival rate of 30% or less.