Adrenal cancer develops in the triangular organ located above the kidney called the adrenal gland. Read the article to know about the cause, symptoms, risk factors, types, diagnosis, and treatment of adrenal cancer.
Adrenal glands are the two triangular glands that are present above the kidneys. The kidneys are located deep inside the upper part of the abdomen. The adrenal gland is an exocrine gland that secretes hormones and gives instructions to all the organs and tissues in the body. Adrenal cancer is also called adrenocortical cancer. It can occur at any age, most probably in children below 5 years and in adults during their 40s and 50s. When it is diagnosed at an early stage, the cure rate is high.
There is no exact cause for adrenal cancer. Adrenal cancer can occur when there is any mutation in the DNA of the adrenal gland cells. Usually, the DNA in the cell instructs the cell on what to do. This type of DNA transformation can instruct the cell to multiply uncontrollably. In this process, the healthy cells turn into abnormal cells and lead to the formation of the tumor. This tumor can also spread to other parts of the body through a process called metastasis.
High blood pressure.
Low potassium level.
Feelings of anxiety or panic attacks.
Excessive hair growth.
Unexplained weight gain or weight loss.
Changes in genitalia.
Change in libido (sex drive).
Abdominal stretch marks.
The people who are at risk for developing adrenal cancer are:
Children who are less than five years of age.
Adults in their 40's and 50's.
People who are exposed to carcinogens.
Genetic syndromes like Li-Fraumeni syndrome, Von Hippel-Lindau disease, Beckwith-Wiedemann syndrome, and multiple endocrine neoplasia type 1 and 2 (MEN1, MEN2).
1. Adrenocortical carcinoma is also called adrenal cortex cancer or adrenal cortical carcinoma (ACC), which is the most common form of adrenal cancer. It usually forms in the cortex's outer layer. It is not detected until the tumor becomes very large. This type of cancer is often discovered after the onset of pain, symptoms, or a feeling of fullness, which results in weight loss. Adrenocortical carcinomas produce excess hormones that may cause excess facial hair, weight gain, or early puberty. Adrenal tumors bigger than 5 to 6 centimeters are considered to be cancer.
2. Pheochromocytoma: This type of adrenal cancer is usually formed in the medulla's central part and typically begins from adrenaline-producing cells. Adrenaline helps to regulate essential bodily functions, including blood pressure and heart rate regulation. Elevated blood pressure, racing heart, excessive sweating, and anxiety are the symptoms of this type of tumor.
3. Neuroblastoma: They are found in the developing nerve cells of the medulla. This type of adrenal cancer usually affects children or infants under the age of 10. Early detection is possible due to the unique nature of the cells. However, the source may be hard to define in some cases since the cells can spread quickly. About one in three neuroblastomas usually begin in the adrenal glands, according to the American Cancer Society.
Blood and Urine Tests: These tests help measure the amount of adrenal hormones and are used to detect a functional tumor. The doctor needs a 24-hour urine sample. This test requires a person to collect urine for an entire 24-hour period for laboratory testing. The test results will help the doctor to track how quickly various hormones are produced. One specific hormone, the doctors, look for in these tests is the stress hormone called cortisol, and a particular test, called a dexamethasone-suppression test, helps to check the cortisol levels.
For this test, the patient may be asked to take a pill the previous evening. This pill acts like cortisol in the body. When people who do not have an adrenal gland tumor take this drug, their bodies will make less cortisol and other hormones. However, if the person has an adrenal gland tumor, cortisol levels will continue to be high even after taking the drug. Inform your doctor about any medications you take, even over-the-counter medicines, herbal pills, or vitamins because this information is needed to interpret the results correctly.
Biopsy: A small amount of tissue is removed for examination under a microscope. If the doctor assumes that cancer has spread from another part of the body to the adrenal gland, a biopsy may be required to determine from where the cancer began, helping the doctor with treatment plan. In biopsy, a narrow, hollow needle is inserted to collect the tissue. This is called a fine-needle aspiration biopsy. A radiologist performs the biopsy along with specialized imaging procedures, such as CT scans, to guide the needle to be inserted directly into the tumor. A pathologist then investigates the sample removed during the biopsy.
CT (computed tomography) or CAT scan: A CT scan is a 3-dimensional picture of the internal body parts using X-rays taken from different angles. A computer will then combine these images into a comprehensive, cross-sectional view that shows any tumors or abnormalities. A special dye called a contrast medium is given before the scan to detail the image. This dye is injected into the patient's vein through a peripheral intravenous (IV) line, a short, plastic tube inserted into the vein helps the health care team give fluids or medication.
MRI (magnetic resonance imaging): An MRI uses magnetic fields and not X-rays to measure the tumor's size. A special dye called a contrast medium is given to the patient before the scan so that it creates a clearer picture. This dye is injected into a patient's vein or given in a pill form to swallow.
Metaiodobenzylguanidine (MIBG) Scan.
Adrenal Vein Sampling (AVS).
Surgery can be used to treat all the stages of cancer of the adrenal gland.
In some advanced adrenal cancer cases, chemotherapy may be used in combination with surgery to destroy cancer cells or keep them from spreading and growing.
Radiation therapy is used to shrink or destroy cancer cells not removed through a surgery. It is often recommended after surgery in patients with advanced adrenal cancer.
For more information, consult a specialist online at iCliniq.com.
Adrenal cancer presents with pinkish or purplish stretch marks on the skin, stiffness of muscles, hormonal changes in both men and women. Hormonal changes are manifested by breast tissue enlargement and testicle shrinkage in men and irregular menstrual cycle, loss of hair on the head, and excess growth of facial hair in women.
Adrenal cancer, if found in the initial stages, can be treated entirely; however, treatment becomes problematic if the tumor has spread to the adjacent areas. In such cases, treatment is mainly aimed at reducing the rate of progression of the disease and reducing the symptoms.
Adrenal tumors increase the level of hormones secreted by the adrenal gland by synthesizing hormones on their own. There is increased production of hormones like cortisol, androgens, estrogens, and aldosterone, which affect the body in several ways. These include weight gain, the appearance of stretch marks, depression, mood swings, increased blood pressure, hormonal changes in males and females, etc.
Benign adrenal adenomas are common in middle-aged and older adults, whereas adrenal carcinomas are extremely rare and are approximately found in about 200 people every year in the United States. About one to two people in every one million are diagnosed with adrenal tumors.
Since the adrenal gland is a vascular organ containing numerous blood vessels, the spread of adrenal tumors is way more aggressive, and metastasis occurs rapidly. These blood vessels carry and spread the malignant cells to the entire body.
Adrenal cancers can also be detected by MRI scan, an imaging test that produces a three-dimensional image of the body structures with the help of magnetic and radio waves. For better enhancement of the pictures, intravenous injection of contrast dyes is done.
Adrenal carcinomas, although very rare, are usually fatal conditions due to the excessive production of hormones associated with them. The five-year survival rate of localized adrenal cancers are 74%, 56% in case of adrenal cancers with a regional spread, and the rate is about 37% in adrenal cancers with distant spread.
Blood tests that detect the level of hormones in the blood are employed to diagnose adrenal cancers. Cortisol, estrogen, androgen, and aldosterone are the hormones whose levels are to be tested.
Adrenal cancer spreads to the bone, blood vessels, and distant organs like the liver and lung.
Adrenal cancer is treated by surgery, radiation therapy, and chemotherapy. In addition to this, a drug called Mitotane is advised in people who have an increased risk of cancer recurrence to prevent the recurrence of adrenal cancer.
Most adrenal cancers show increased production of cortisol which results in Cushing's syndrome. In adrenal cancers, which involve the production of testosterone, Virilizing syndrome is caused. Although rare, excess production of aldosterone in adrenal cancers causes Conn syndrome.
- Extra facial or body hair.
- Larger clitoris in girls.
- Early puberty or breast development in girls.
- Post-menopausal spotting.
- Deeper voice.
- Irregular menstrual cycle.
CT scan helps in diagnosing the exact location of the adrenal tumor. It also shows the metastatic spread of cancer to the liver, regional lymph nodes, nearby organs, and distant organs.
Last reviewed at:
22 Sep 2021 - 4 min read
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