» » Adreno Cortical Carcinoma - Symptoms and Diagnosis

Adreno Cortical Carcinoma / Adreno Cortical Cancer / Cancer of the Adrenal Cortex / Adrenal Cortex Cancer

Rating : 12345
Rate This Article : 1 2 3 4 5
G J 4
A -A +

Symptoms and Diagnosis

Adrenocortical carcinoma (ACC) usually present with either hormone excess (Cushing’s syndrome, virilization or symptoms associated with low potassium) or a local mass effect when the tumor is in excess of 10 cm.


Adrenocortical carcinoma with functional tumors involves hormonal dysfunction and is characterizedby –

• Cushing’s syndrome – due to High serum Cortisol Levels,

• Conn syndrome - due to high Aldosterone levels

• Virilization or feminization – due to high levels of testosterone in women and oestrogen in men.

Adrenocortical carcinoma presents itself differently in children (virilization - presenting symptom) and adults (Cushing’s syndrome-presenting symptom).

The prominent symptoms and signs of Adrenocortical carcinoma are -

Cushing syndrome - due to increased cortisol levels or glucocorticoids.

- weight gain,

- purple lines on abdomen,

- muscle wasting,

- fatty ‘buffalo’ hump on neck, thin fragile skin,

- ‘moon-like’ face - flushed rounded face with pudgy cheeks

Conn syndrome due to High levels of Aldosterone or mineralocorticoids-

- High Blood Pressure

- Headache,

- Hypokalemia (low potassium),

- Muscle weakness,

- Palpitations

- Confusions

- Increased thirst

- Increased urination

Virilism - due to androgen or testostosterone excess – affects women

- Acne,

- Excess facial and body hair,

- Enlarged clitoris,

- Coarse facial features,

- Deep voice,

- Menopause

Feminization - due to estrogen excess seen in men -

- Breast enlargement,

- Low libido,

- Impotence

Non-functional carcinomas can present as abdominal mass and flank pain. They can often present late. They are often detected on routine investigations such as ultrasound.

Pathobiology / Causes

The main cause of adrenocortical cancer is unknown. However several causes are implicated.

• A family history of Fraumeni syndrome generates an increased risk

• Tumor suppressor genes such as p53 and RB(retinoblastoma) protein are altered.

• The expressions of genes h19 and insulin-like growth factor II ( essential for fetal development) are decreased and increased respectively.

• The expression of the c-myc gene is relatively high in these cancers and is associated with poor prognosis.


Diagnosis of adrenocortical cancer is based on the following tests -

• Blood Pressure is High

• Serum Cortisol levels are High

• Serum Aldosterone level is High

• Serum ACTH level is Low

• Serum Potassium is Low

• CT scan of the abdomen

• Abdominal MRI

Microscopic examinations of biopsied samples confirms the diagnosis.

Post your Comments

Comments should be on the topic and should not be abusive. The editorial team reserves the right to review and moderate the comments posted on the site.
User Avatar
* Your comment can be maximum of 2500 characters
Notify me when reply is posted I agree to the terms and conditions

Ask an Expert

If you have a question about health related issues, you can now post it in our Ask An Expert section on our community website and get answers from our panel of experts.

You May Also Like

View All