Adrenocortical carcinoma is an uncommon form of cancer that begins in the inner lining of an adrenal gland. Tumors tend to grow slowly, and many people do not experience symptoms until cancer has already started to spread to other parts of the body. It is possible for an adrenocortical carcinoma tumor to begin overproducing the hormones normally secreted by the adrenal glands, which can lead to muscle deterioration, disfigurement of the face and back, and excess hair growth. The cancer is usually curable if a mass is detected early and surgically removed. The survival rate is relatively low once cancer starts to spread beyond the initial tumor.
The adrenal glands secrete important regulatory hormones that control stress levels, blood pressure, and many essential bodily processes. When a cancerous tumor develops in the hormone-producing layer of tissue called the cortex, it can start to manufacture massive quantities of aldosterone and cortisol. Adrenocortical carcinomas that increase hormone production are deemed functional, and are much more common in young children than in adults. Nonfunctional carcinomas, which tend to arise between the ages of 30 and 40, typically do not impact normal adrenal gland processes.
When a functional adrenocortical carcinoma overproduces cortisol and aldosterone, a child may experience excessive weight gain and stunted growth. Muscle loss and fatty buildups can give the face a rounded appearance and cause a hump to appear on the back just below the neck. Girls often begin to exhibit male sex characteristics, such as an increase in body and facial hair, acne, a deepening voice, and an enlarged clitoris. Adults with nonfunctional adrenocortical carcinoma may have fatigue, weight loss, and frequent muscle cramps.
A doctor can check for signs of adrenocortical carcinoma by collecting blood samples and taking x-rays and ultrasounds of the abdomen. Blood tests may reveal high hormone levels and low potassium. Diagnostic imaging scans usually show a dark mass growing on an adrenal gland. If the doctor is unsure whether or not the tumor is cancerous, he or she may decide to surgically collect a tissue sample for laboratory testing.
A tumor that is small and isolated to the adrenal gland can be removed surgically. A surgeon may choose to make a large incision in the lower back to get access to the mass or manipulate an endoscope and scalpel through a smaller cut in the side. Chemotherapy and radiation treatments are necessary if cancer spreads to the abdomen, lungs, bones, or elsewhere in the body. In addition, patients may need to receive hormone therapy to help manage symptoms during cancer treatment.
