How Is Adrenocortical Carcinoma Diagnosed?

Reviewed on 2/18/2022
A lab technician pulling out a blood sample from several different samples
Imaging studies and tests used to diagnose adrenocortical carcinoma include computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, adrenal angiography, adrenal venography, positron emission tomography (PET) scan, MIBG scan, biopsy, blood tests, and urine tests.

Adrenocortical carcinoma (also called cancer of the adrenal cortex) is a rare disease in which malignant (cancer) cells form in the outer layer of the adrenal gland. 

In addition to a medical history and physical examination, adrenocortical carcinoma is diagnosed using imaging studies, blood tests, and urine tests, such as: 

  • Imaging tests
    • Computed tomography (CT) scan 
    • Magnetic resonance imaging (MRI) scan or nuclear magnetic resonance imaging (NMRI) scan
    • Adrenal angiography    
    • Adrenal venography    
    • Positron emission tomography (PET) scan
    • MIBG scan
  • Blood or urine tests
    • Low-dose dexamethasone suppression test
    • High-dose dexamethasone suppression test
  • Urine test
    • Twenty-four-hour urine test
  • Blood tests 
    • Blood chemistry   
  • Biopsy

What Are Symptoms of Adrenocortical Carcinoma?

Adrenocortical carcinoma tumors may be considered functioning (producing more hormones than normal) or nonfunctioning (does not produce more hormones than normal). Most adrenocortical tumors are functioning, and the hormones produced may cause symptoms.

In the early stages, a nonfunctioning adrenocortical tumor may not have symptoms. When symptoms of adrenocortical carcinoma occur, they may include: 

Symptoms of excess cortisol production due to adrenocortical carcinoma may include:

  • Weight gain in the face, neck, and trunk 
  • Thin arms and legs
  • Fine hair growth on the face, upper back, or arms
  • Round, red, full face
  • Lump of fat on the back of the neck
  • Deepened voice and swelling of genitals or breasts in both males and females
  • High blood pressure (hypertension)
  • Muscle weakness
  • High blood sugar

Symptoms of excess aldosterone production due to adrenocortical carcinoma may include:

Symptoms of excess testosterone production in women due to adrenocortical carcinoma may include:

  • Fine hair growth on the face, upper back, or arms
  • Acne
  • Balding
  • Deepened voice
  • Cessation of menstrual periods

Excess testosterone in men does not usually cause symptoms.

Symptoms of excess estrogen production in women due to adrenocortical carcinoma may include:

  • Irregular menstrual periods 
  • Vaginal bleeding in post-menopausal women 
  • Weight gain

Symptoms of excess estrogen production in men due to adrenocortical carcinoma may include:

What Causes Adrenocortical Carcinoma?

The exact cause of adrenocortical carcinoma is unknown. 

Risk factors for developing adrenocortical carcinoma include hereditary diseases such as:

  • Li-Fraumeni syndrome
  • Beckwith-Wiedemann syndrome
  • Carney complex

What Is the Treatment for Adrenocortical Carcinoma?

Treatments for adrenocortical carcinoma include surgery, radiation therapy, and chemotherapy

  • Surgery to remove the adrenal gland (adrenalectomy) is the most common treatment for adrenocortical carcinoma
    • Removal of nearby lymph nodes and other tissue where the cancer has spread may also be indicated
  • Radiation therapy
    • Uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing
      • External radiation therapy 
      • Internal radiation therapy 
  • Chemotherapy (“chemo”)
    • Systemic chemotherapy 
    • Regional chemotherapy
    • Combination chemotherapy
  • Clinical trials
    • Immunotherapy
      • A type of biologic therapy, immunotherapy uses substances made by the body or in a lab to boost, direct, or restore the body's natural defenses against cancer
    • Targeted therapy
      • Uses drugs or other substances to identify and attack specific cancer cells
      • Usually causes less harm to normal cells than chemotherapy or radiation therapy 
Reviewed on 2/18/2022
Image Source: iStock Images