Adrenal carcinoma

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Classification according to ICD-10
C74 Malignant neoplasm of the adrenal gland
C74.0 Adrenal cortex
ICD-10 online (WHO version 2019)

The adrenocortical carcinoma is one of the adrenal cortex outgoing rare tumor . It can affect all 3 layers of the adrenal cortex.

Symptoms

Carcinoma of the adrenal cortex is usually associated with increased hormone production , which is why hyperaldosteronism (due to increased production of aldosterone ), Cushing's syndrome (due to increased production of cortisol ) and virilization (due to increased production of androgens ) are typical. Other unspecific symptoms such as B. Abdominal pain , weight loss and fatigue may occur.

diagnosis

The hormone levels of estrogen , aldosterone , cortisol and the increase in androgens are examined. The size, extent and weight of the tumor are assessed using MRI or CT . When it is discovered, the tumor is usually larger than 8 cm in diameter.

therapy

Radical adrenalectomy is the only curative therapy . The prerequisite is freedom from distant metastases . Infiltrated neighboring tissues are also removed.

Furthermore, a radical regional lymphadenectomy with removal of the retroperitoneal fat tissue between the diaphragm and the kidney stalk is performed. Lymph nodes located between the aorta and inferior vena cava are also resected . For the sake of clarity, access is thoraco- abdominal .

Inoperable adrenal carcinoma can be treated with mitotane , a cytostatic agent that selectively inhibits cell division in the adrenal cortex .

The prognosis is poor overall and the response to drug therapy is unsatisfactory.

Individual evidence

  1. ^ A b c d e W. Siegenthaler: Clinical Pathophysiology. Thieme Verlag, 2006, ISBN 3-13-449609-7 , pp. 343–4, (online)