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{{Adrenocortical carcinoma}}
{{Adrenocortical carcinoma}}
{{CMG}}; {{AE}} {{RT}}{{AAM}}
{{CMG}}; {{AE}} {{RT}} {{AAM}} {{MAD}}
==Overview==
==Overview==
Adrenocortical carcinoma may present differently in children and adults.  Most tumors in children are functional, and [[virilization]] is by far the most common presenting symptom, followed by [[Cushing's syndrome]] and [[precocious puberty]]. Among adults presenting with hormonal syndromes, Cushing's syndrome alone is most common, followed by mixed Cushing's and virilization ([[glucocorticoid]] and [[androgen]] overproduction). [[Feminization]] and [[Conn syndrome]] ([[mineralcorticoid]] excess) occur in less than 10% of cases. Rarely, [[pheochromocytoma]]-like hypersecretion of [[catecholamine]]s has been reported in adrenocortical cancers.<ref name="Weidner's">{{cite book |author=Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) |title=Modern Surgical Pathology (2 Volume Set) |publisher=W B Saunders |location=London |year= |pages= |isbn=0-7216-7253-1 |oclc= |doi=}}</ref> Non-functional tumors (about 40%, authorities vary) usually present with abdominal or flank pain, or they may be asymptomatic and detected incidentally.
Symptoms of [[adrenocortical carcinoma]] include symptoms of [[androgen]], [[glucocorticoid]], [[mineralocorticoid]], or [[estrogen]] excess. Symptoms of [[glucocorticoid]] excess include [[Weight gain]], [[Acne]], irritability. Symptoms of [[androgen]] excess include [[hirsuitism|hirsutism]], [[Irritability|acne]], and [[Irritability|deepening of the voice.]] Symptoms [[Irritability|of]] [[mineralcorticoid|mineralocorticoid]] excess include [[headache]], [[Muscle weakness|muscle weakness,]] [[Confusion]], and [[Palpitations|palpitations.]]
==Common Symptoms==
60 percent of [[adrenocortical carcinoma]] (ACC) are sufficiently secretory to present clinical syndrome of hormone excess.<ref name="pmid16551738">{{cite journal| author=Allolio B, Fassnacht M| title=Clinical review: Adrenocortical carcinoma: clinical update. | journal=J Clin Endocrinol Metab | year= 2006 | volume= 91 | issue= 6 | pages= 2027-37 | pmid=16551738 | doi=10.1210/jc.2005-2639 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16551738  }}</ref>
* 45% of ACCs show symptoms of [[Cushing's syndrome]] alone.
* 25% present with mixed overproduction of both [[glucocorticoids]] and [[androgens]]. <ref name="pmid10679640">{{cite journal| author=Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA et al.| title=Adrenocortical carcinoma: clinical and laboratory observations. | journal=Cancer | year= 2000 | volume= 88 | issue= 4 | pages= 711-36 | pmid=10679640 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10679640  }}</ref>
* 10% present with [[virilization]] alone.
1- Symptoms of [[glucocorticoid]] excess include: <ref>{{Cite journal


==History==
| author = [[Bibek Bista]] & [[Nancy Beck]]
==Common symptoms==
| title = Cushing syndrome
All patients with suspected adrenocortical carcinoma should be carefully evaluated for signs and symptoms of hormonal syndromes.
| journal = [[Indian journal of pediatrics]]
This may include the followings:
| volume = 81
| issue = 2
| pages = 158–164
| year = 2014
  | doi = 10.1007/s12098-013-1203-8
| pmid = 24062268
}}</ref>
*[[Weight gain]]
*[[Acne]]
*[[Irritability]]
*[[Insomnia]]


1- [[Glucocorticoid]] excess symptoms include:  
2- Symptoms of [[androgen]] excess [[symptoms]] in women include: <ref>{{Cite journal
:*[[Weight gain]]
 
:*[[Muscle wasting]]
| author = [[Lourdes Ibanez]], [[Ken K. Ong]], [[Abel Lopez-Bermejo]], [[David B. Dunger]] & [[Francis de Zegher]]
:*Purple lines on the abdomen
| title = Hyperinsulinaemic androgen excess in adolescent girls
:*[[Buffalo hump]]
| journal = [[Nature reviews. Endocrinology]]
:*[[Moon face|Moonlike face]]
| volume = 10
:*Thin, fragile skin.
| issue = 8
2-[[Androgen]] excess symptoms (most readily noted in females) include:
| pages = 499–508
:*[[Hirsutism|excess facial and body hair]]
| year = 2014
:*[[Acne]]
| doi = 10.1038/nrendo.2014.58
:*[[Clitoromegaly]]
| pmid = 24776733
:*Deepening of the voice
}}</ref>
:*Coarsening of facial features
*[[Hirsutism|Excess facial and body hair]]
:*[[Amenorrhea|Cessation of menstruation]].
*[[Acne]]
3-[[Mineralcorticoid]] excess symptoms include:
*Deepening of the voice
:*[[Headache]]
*Coarsening of [[facial]] features
:*[[Muscle weakness]]
*[[Amenorrhea|Cessation of menstruation]]
:*[[Confusion]]
3- Symptoms of [[mineralcorticoid|mineralocorticoid]] excess include: <ref>{{Cite journal
:*[[Palpitations]]
 
4-[[Estrogen]] excess symptoms (most readily noted in males)include:  
| author = [[Valeria Bisogni]], [[Gian Paolo Rossi]] & [[Lorenzo A. Calo]]
:*[[Gynecomastia|breast enlargement]]
| title = Apparent mineralcorticoid excess syndrome, an often forgotten or unrecognized cause of hypokalemia and hypertension: case report and appraisal of the pathophysiology
:*Decreased [[libido]]
| journal = [[Blood pressure]]
:*[[Impotence]].<ref>Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL. ''Harrison's Principles of Internal Medicine''. New York: McGraw-Hill, 2005. ISBN 0-07-139140-1</ref>
| volume = 23
| issue = 3
| pages = 189–192
| year = 2014
| doi = 10.3109/08037051.2013.832967
| pmid = 24053336
}}</ref>
*[[Headache]]
*[[Muscle weakness]]
*[[Confusion]]
*[[Palpitations]]
4- Symptoms of [[estrogen]] excess in men include: <ref>{{Cite journal
 
| author = [[G. M. Zanetta]], [[M. J. Webb]], [[H. Li]] & [[G. L. Keeney]]
| title = Hyperestrogenism: a relevant risk factor for the development of cancer from endometriosis
| journal = [[Gynecologic oncology]]
| volume = 79
| issue = 1
| pages = 18–22
| year = 2000
| doi = 10.1006/gyno.2000.5905
| pmid = 11006024
}}</ref>
*[[Gynecomastia]]
*Decreased [[libido]]
*[[Impotence]]
 
5- Symptoms of [[catecholamine]]s excess has been reported in adrenocortical cancers: <ref name="Weidner's">{{cite book |author=Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) |title=Modern Surgical Pathology (2 Volume Set) |publisher=W B Saunders |location=London |year= |pages= |isbn=0-7216-7253-1 |oclc= |doi=}}</ref>
*[[Headache]]
*[[Sweating]]
*[[Palpitation]]
 
6- Other symptoms may include: <ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/adrenocortical/patient/adrenocortical-treatment-pdq#section/_1</ref>
*[[Abdominal mass|Abdominal lump]]
*[[Abdominal]] or [[back pain]]
*[[Abdominal]] fullness
7- Children usually present with [[virilization]] (84%), while isolated [[glucocorticoid]] excess is much less common (6%). <ref name="pmid15137014">{{cite journal| author=Stewart JN, Flageole H, Kavan P| title=A surgical approach to adrenocortical tumors in children: the mainstay of treatment. | journal=J Pediatr Surg | year= 2004 | volume= 39 | issue= 5 | pages= 759-63 | pmid=15137014 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15137014  }}</ref>


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Endocrinology]]
[[Category:Types of cancer]]
[[Category:Disease]]
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Latest revision as of 18:58, 30 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Ahmad Al Maradni, M.D. [3] Mohammed Abdelwahed M.D[4]

Overview

Symptoms of adrenocortical carcinoma include symptoms of androgen, glucocorticoid, mineralocorticoid, or estrogen excess. Symptoms of glucocorticoid excess include Weight gain, Acne, irritability. Symptoms of androgen excess include hirsutism, acne, and deepening of the voice. Symptoms of mineralocorticoid excess include headache, muscle weakness, Confusion, and palpitations.

Common Symptoms

60 percent of adrenocortical carcinoma (ACC) are sufficiently secretory to present clinical syndrome of hormone excess.[1]

1- Symptoms of glucocorticoid excess include: [3]

2- Symptoms of androgen excess symptoms in women include: [4]

3- Symptoms of mineralocorticoid excess include: [5]

4- Symptoms of estrogen excess in men include: [6]

5- Symptoms of catecholamines excess has been reported in adrenocortical cancers: [7]

6- Other symptoms may include: [8]

7- Children usually present with virilization (84%), while isolated glucocorticoid excess is much less common (6%). [9]

References

  1. Allolio B, Fassnacht M (2006). "Clinical review: Adrenocortical carcinoma: clinical update". J Clin Endocrinol Metab. 91 (6): 2027–37. doi:10.1210/jc.2005-2639. PMID 16551738.
  2. Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA; et al. (2000). "Adrenocortical carcinoma: clinical and laboratory observations". Cancer. 88 (4): 711–36. PMID 10679640.
  3. Bibek Bista & Nancy Beck (2014). "Cushing syndrome". Indian journal of pediatrics. 81 (2): 158–164. doi:10.1007/s12098-013-1203-8. PMID 24062268.
  4. Lourdes Ibanez, Ken K. Ong, Abel Lopez-Bermejo, David B. Dunger & Francis de Zegher (2014). "Hyperinsulinaemic androgen excess in adolescent girls". Nature reviews. Endocrinology. 10 (8): 499–508. doi:10.1038/nrendo.2014.58. PMID 24776733.
  5. Valeria Bisogni, Gian Paolo Rossi & Lorenzo A. Calo (2014). "Apparent mineralcorticoid excess syndrome, an often forgotten or unrecognized cause of hypokalemia and hypertension: case report and appraisal of the pathophysiology". Blood pressure. 23 (3): 189–192. doi:10.3109/08037051.2013.832967. PMID 24053336.
  6. G. M. Zanetta, M. J. Webb, H. Li & G. L. Keeney (2000). "Hyperestrogenism: a relevant risk factor for the development of cancer from endometriosis". Gynecologic oncology. 79 (1): 18–22. doi:10.1006/gyno.2000.5905. PMID 11006024.
  7. Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor). Modern Surgical Pathology (2 Volume Set). London: W B Saunders. ISBN 0-7216-7253-1.
  8. National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/adrenocortical/patient/adrenocortical-treatment-pdq#section/_1
  9. Stewart JN, Flageole H, Kavan P (2004). "A surgical approach to adrenocortical tumors in children: the mainstay of treatment". J Pediatr Surg. 39 (5): 759–63. PMID 15137014.