Adrenocortical carcinoma is rather rare malignant tumor and it affects only one or two persons in a million. The tumor predominantly affects adults and the medium age at diagnosis is 44. As any other malignant tumor even adrenal gland carcinoma is curable if diagnosed at early stages. However, early setting of the diagnosis occurs only in 30% percent of all patients. Adrenal gland carcinoma grows uncontrollably and invades and destroys the surrounding tissues and organs. It may also spread to distant organs and give metastases. In some cases adrenal gland carcinomas are hormonally active.
Presentation and Characteristics of Adrenal Gland Cancer
Adrenal gland carcinomas are considered very aggressive tumors. Approximately 60% of all adrenal gland tumors are hormonally active and specific changes in the body due to production of certain hormones lead to symptoms and signs which eventually drive patients to see their health care providers. The tumor may even produce several adrenal hormones at the same time.
Once the tumor has grown to a certain size patients may complain about the pain in the abdomen or flank area. The symptoms or signs of the disease may also occur once the tumor has spread to distant organs such as lungs, liver, abdominal cavity or bones. In this case the symptoms and signs differ according to the very site of the metastases.
Diagnosing Adrenal Gland Cancer
Once the patients have come to see a doctor they undergo many tests and examinations. Apart from physical examination the first thing a doctor does is taking blood sample and measuring the level of adrenal gland hormones. This is performed initially since many of adrenal gland cancers are hormonally active. But increased production of adrenal hormones is also a characteristic of benign tumors of this gland. So just by measuring the level of hormones we can establish if the tumor produces increased level of specific hormone but we are not able to tell whether the tumor is benign or malignant.
What follows next is CT scan or MRI of the adrenal glands and surrounding tissues. These imaging techniques perfectly visualize the tumor and may be more precise in telling whether the tumor is malignant of benign. And only after being surgically removed and pathohistologically examined the tumor can be classified as malignant or benign.
Treatment for Adrenal Gland Cancer
The size, the type of adrenal cancer as well as the stage of the disease determines the treatment. In case that the cancer has not spread to surrounding tissues and distant organs patients are treated surgically. There are several surgical procedures applied in order to remove the cancer from the body. They include laparoscopic adrenalectomy, posterior surgery, transabdominal surgery and thoracoabdominal surgery.
If the cancer is too large and cannot be safely removed surgeons usually perform cryoablation and radiofrequency ablation.
Debulking surgery is indicated in patients with metastatic form of the disease. Chemotherapy is basically administered if the surgery cannot cure the cancer. This also refers to radiation therapy. And finally, patients may benefit from certain medications which control the symptoms of the disease related to hormones produced by adrenal cancer.