Acute Adrenocortical Carcinoma

What is acute adrenocortical carcinoma?

Acute adrenocortical carcinoma is just one of those rare diseases you can think of. But this time, the organ it affects is the adrenal gland specifically the outer part of it called, the cortex.  The adrenal cortex begins to produce cells in extremely large numbers because of its tumor. These cells may eventually become cancerous. And that’s what adrenal cortical carcinoma is all about. It is also called adrenocortical carcinoma.

If you choose to investigate the anatomy of the adrenal gland, you will find out that it is lying comfortably on the kidneys! There is no way you mention or want to write about the endocrine system of the body that the adrenal gland will not be amongst the first three that will be mentioned. This shows you how important this gland is.  It produces hormones (cortisol, androgens etc.) that are vital in the regulation of blood pressure, metabolism, and sexual reproduction, especially in males. Adrenocortical carcinoma will hence produce these hormones in excess.

 

Acute adrenocortical carcinoma

Photo Credit: American Urological Association

 

The two types of acute adrenocortical carcinoma

Functioning tumors:  In functioning tumors, a copious quantity of testosterone, cortisol, and aldosterone are produced in the body. Aldosterone is a blood pressure regulator.

Nonfunctioning tumors:  In nonfunctioning tumors, there is no increased production of aldosterone, testosterone, and cortisol.

Most of the tumors formed in the adrenal gland seem not to be cancerous. Only about 5-10% will be cancerous.

 

Causes of acute adrenocortical carcinoma

It is unknown yet but it can develop when non-adrenal cancerous cells get to the adrenal cortex. This is often referred to as secondary cancer.

 

Risk factors for acute adrenocortical carcinoma

Some of the risk factors for acute adrenal cortical carcinoma have been identified by scientists. It will be more risky for the following categories:

  • Females
  • People not less than 40 and  not more than 50 years old
  • Children below age 5
  • People with hereditary diseases affecting the adrenal glands
  • People who have different aggressive cancer

 

Common symptoms of adrenocortical carcinoma

Symptoms will be determined by the hormone affected the most especially for functioning tumors.

Testosterone and other androgens:

  • Increased production of hairs on the face and body. This will be pronounced in females.
  • A masculine voice in females

Estrogen:

  • Early puberty in children
  • The growth of breast tissues in males

Aldosterone:

  • Increased weight gain
  • Increased blood pressure

Cortisol:

  • Increased blood pressure
  • Increased sugar in the blood
  • Weak legs because of weak muscles
  • Sustained body bruising
  • Accumulation of fat in the chest and abdominal regions
  • Abdominal pains in the two tumor types – functioning and nonfunctioning

Tumors that are nonfunctioning might not have alterations in the hormones or cause typical symptoms.

Too much cortisol production in the cortex of the adrenal gland can cause Cushing’s syndrome. Adrenal tumors responsible for Cushing syndrome are noncancerous.

 

Diagnosis of adrenocortical carcinoma

It will follow the pattern of most diagnosis. The first approach will be to physically examine you by your doctor. After this, he will get samples of your blood, saliva, and urine and will order laboratory tests that will assess your hormonal levels.

Imaging tests such as MRI (magnetic resonance imaging), CT (computed tomography) scan or PET (positron emission tomography) scan will be further used to assess the nature of the tumor.

The tumor will then be investigated by getting some tissues from it for a biopsy. In a biopsy, the tissue is studied closely to ascertain the type of cells it has, whether they are noncancerous or cancerous.

 

Treatment for acute adrenocortical carcinoma

Upon the completion of the diagnosis of the condition, a plan of treatment will be drawn by your doctor. The plan will factor in your gender, age, the stage of cancer and indeed your overall health.

 

The four (4) stages of a tumor based on their size:

  • Stage 1 tumors: These tumors are small and actually less than 5cm inside the tissues.
  • Stage 2 tumors: These tumors are large and are greater than 5cm inside the tissues.
  • Stage 3 tumors: These tumors don’t have any particular size. They have invaded surrounding fat cells and lymph nodes.
  • Stage 4 tumors: These tumors just like the stage three tumors don’t have a particular size. They have taken over other tissues and organs in the body.

Based on these four stages of a tumor, the following treatment can be adapted to treat the tumor peculiar to your condition.

Chemotherapy:  In chemotherapy, medications are employed to destroy the cancerous cells produced by the tumor. They could be in tablet or injection forms.

Surgery: When needful, surgery will be used to extract the tumors.

Radiation: Here, radioactive substances are applied to the tumor to shrink them. Two ways exist in achieving this: externally applying radioactive substances to your body, and internally applying radioactive substances on the tumors through the use of wires, needle or catheters.

Biologic therapy: Here, your body’s immune system will be used to fight the cancerous cells.

Prognosis

This will largely depend on the stage of your cancer. It will also affect the treatment plan. Your response to treatment will be constantly checked by your doctor through follow-ups. In cases where the tumor returns, the follow-ups can easily detect it and promptly treated.

Because the hormonal changes associated with adrenal tumors can induce other health issues, you will be monitored by your doctor to ensure that such illnesses are kept at bay.

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