Adrenocortical carcinoma CT: Difference between revisions

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{{Adrenocortical carcinoma}}
{{Adrenocortical carcinoma}}
{{CMG}} {{AE}} {{AAM}}
{{CMG}}; {{AE}} {{AAM}} {{MAD}}
==Overview==
==Overview==
Adrenal CT scan may be helpful in the diagnosis of Adrenocortical carcinoma.
Adrenal CT scan may be helpful in the diagnosis of Adrenocortical carcinoma.
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:* Differentiating it from other diseases, such as [[adrenocortical adenoma]]
:* Differentiating it from other diseases, such as [[adrenocortical adenoma]]
:* Determining the extent of invasion of the tumor into surrounding organs and tissue  
:* Determining the extent of invasion of the tumor into surrounding organs and tissue  
:* Ct=T scan of the [[chest]] are routinely performed to look for[[metastasis|metastases]] to the [[lung]]s  Signs can be detected on CT scan:  ACCs are large, heterogeneous enhancing masses of soft tissue attenuation.   Internal hemorrhage is seen as ill-defined areas of increased attenuation on non-contrast-enhanced CT and as areas of high signal intensity on T1-weighted images
:* Ct=T scan of the [[chest]] are routinely performed to look for[[metastasis|metastases]] to the [[lung]]s   
:Areas of necrosis have low attenuation on non–contrast-enhanced CT, high signal intensity on T2-weighted images and do not enhance after administration of iv contrast (105).
*Signs can be detected on CT scan:   
* Calcifications, which are best detected on CT imaging as high attenuation foci, can be present in approximately30%of cases. These are either coarse calcifications or microcalcifications and usually centrally located. Calcification is also present in other adrenal pathologies such as myelolipoma and 10% of pheochromocytomas and hence is not a distinguishing feature (106).  
**ACCs are large, heterogeneous enhancing masses of soft tissue attenuation.  
 
**Internal hemorrhage is seen as ill-defined areas of increased attenuation on non-contrast-enhanced CT and as areas of high signal intensity on T1-weighted images
* Some ACCs may contain areas of intracellular lipid and rarely macroscopic fat resulting in CT density measurements of 10 HU in portions of the tumor (107).
**Areas of necrosis have low attenuation on non–contrast-enhanced CT, high signal intensity on T2-weighted images and do not enhance after administration of iv contrast (105).
 
**Calcifications, which are best detected on CT imaging as high attenuation foci, can be present in approximately30%of cases. These are either coarse calcifications or microcalcifications and usually centrally located. Calcification is also present in other adrenal pathologies such as myelolipoma and 10% of pheochromocytomas and hence is not a distinguishing feature (106).  
* Contrast-enhanced imaging often demonstrates heterogeneous, predominantly irregular peripheral enhancement with central nonenhancing areas secondary to
**Some ACCs may contain areas of intracellular lipid and rarely macroscopic fat resulting in CT density measurements of 10 HU in portions of the tumor (107).
**Contrast-enhanced imaging often demonstrates heterogeneous, predominantly irregular peripheral enhancement with central nonenhancing areas secondary to
hemorrhage or necrosis. Contrast-enhanced CT scan is a reliable method of disease staging, identifying common metastatic sites such as regional and para-aortic lymph nodes, lungs, liver, and bones (98).  
hemorrhage or necrosis. Contrast-enhanced CT scan is a reliable method of disease staging, identifying common metastatic sites such as regional and para-aortic lymph nodes, lungs, liver, and bones (98).  
* CT imaging of the chest, liver, and bone scan are used for staging workup to detect metastasis.
**CT imaging of the chest, liver, and bone scan are used for staging workup to detect metastasis.
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 13:36, 20 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2] Mohammed Abdelwahed M.D[3]

Overview

Adrenal CT scan may be helpful in the diagnosis of Adrenocortical carcinoma.

Key CT Findings in adrenocortical carcinoma

  • CT scan of the abdomen is useful for:
  • Identifying the site of the tumor
  • Differentiating it from other diseases, such as adrenocortical adenoma
  • Determining the extent of invasion of the tumor into surrounding organs and tissue
  • Ct=T scan of the chest are routinely performed to look formetastases to the lungs
  • Signs can be detected on CT scan:
    • ACCs are large, heterogeneous enhancing masses of soft tissue attenuation.
    • Internal hemorrhage is seen as ill-defined areas of increased attenuation on non-contrast-enhanced CT and as areas of high signal intensity on T1-weighted images
    • Areas of necrosis have low attenuation on non–contrast-enhanced CT, high signal intensity on T2-weighted images and do not enhance after administration of iv contrast (105).
    • Calcifications, which are best detected on CT imaging as high attenuation foci, can be present in approximately30%of cases. These are either coarse calcifications or microcalcifications and usually centrally located. Calcification is also present in other adrenal pathologies such as myelolipoma and 10% of pheochromocytomas and hence is not a distinguishing feature (106).
    • Some ACCs may contain areas of intracellular lipid and rarely macroscopic fat resulting in CT density measurements of 10 HU in portions of the tumor (107).
    • Contrast-enhanced imaging often demonstrates heterogeneous, predominantly irregular peripheral enhancement with central nonenhancing areas secondary to

hemorrhage or necrosis. Contrast-enhanced CT scan is a reliable method of disease staging, identifying common metastatic sites such as regional and para-aortic lymph nodes, lungs, liver, and bones (98).

    • CT imaging of the chest, liver, and bone scan are used for staging workup to detect metastasis.

References

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