What Is Adrenocortical Carcinoma?

By Paul A Morales

Adrenocortical carcinomas are uncommon malignancies that affect the adrenal cortex (outermost layer of the adrenal glands). These glands are found on top of the kidneys, and are responsible for producing hormones which control some body functions. These hormones include adrenaline, noradrenaline (which control heart rate, blood pressure, etc.), steroids, and some sex hormones (estrogen, testosterone).

Occurrence
Its occurrence is noted most on children younger than five years old, and to adults in their thirties and forties. It is found on both males and females. It is rare, as the chance of getting this type of carcinoma is two out of one million.

Causes
The causes of having this type of carcinoma are unknown, but it may be linked on genetics. People with family members affected with this type have been theorized to have increased risk of getting this type.

Signs and Symptoms
As the tumor develops in the gland, some/all hormones that the gland produces also increase in the bloodstream. This increase can lead to several symptoms that may depend on what hormone levels are affected.

Cortisol: Cortisol is a hormone that is responsible for carbohydrate metabolism, and to the body's response to stress. Its increase can produce symptoms which mimic those of Cushing's disease. These symptoms may include:

Buffalo hump: a hump found almost on the nape area of the body, which is usually made up of fat;

Moon face: a change in the patient's face, which produces puffy cheeks, and makes it rounded, resembling that of a full moon;

Virilization: male sexual characteristics become more prominent in both males and females, which causes increased hair growth in some parts of the body, deepening of the voice, and acne.

Aldosterone: Aldosterone is a hormone responsible for salt (sodium and potassium) and water balance in the body. Increase of this hormone can cause symptoms, such as:
Increased thirst: because of increased sodium in the body, and; muscle cramps and weakness: because of electrolyte imbalance.

Diagnosis

Diagnosis of adrenocortical carcinomas will depend on the approach prescribed by the examiner. The physician can use several methods in order to properly diagnose if one has this type of cancer.

Symptom analysis: using the symptoms provided above, the doctor can already suspect that a patient has this type of cancer.

Laboratory tests: using different blood chemistry and hormonal analysis, a physician can see results such as increased blood glucose (because of increased cortisol), and change of hormonal levels from its normal limits.

Radiology: the tumor formed can be visualized through the use of different radiologic examinations, which can include X-ray, CT Scan, and Magnetic Resonance Imaging (MRI)

Pathology: the physician can request extraction of a part of the tumor through different methods, and confirm its malignancy by doing a biopsy.

Treatment
The initial and the only treatment of this type of cancer is through removal of the tumor itself, especially when it has already affected some major blood vessels. If surgery is successful, the chances of living for five more years will be increased to fifty to sixty percent. However, not all of the patients are surgical candidates. If the patients will not be able to undergo surgery, some approaches such as radiotherapy, and radiofrequency ablation will be taken. Medications to control the production of cortisol might be given, as most of the symptoms are caused by increased cortisol.

Adrenal carcinoma is a dangerous and possibly fatal type of cancer. However, knowing Adrenal carcinoma and consulting your physician as early as soon as possible can help in early management and treatment of the disease.

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