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Adrenocortical carcinoma is a rare type of cancer that starts in the outer layer of the adrenal glands. These small glands sit above the kidneys and produce hormones that help control blood pressure, metabolism, stress responses, and other important body functions.

This cancer can sometimes grow quickly and affect nearby organs. It may also cause changes in hormone levels, leading to noticeable symptoms. Understanding its warning signs, diagnosis, and treatment options can help people seek medical care at the right time.

What Is Adrenocortical Carcinoma?

The adrenal glands have two main parts: the outer cortex and the inner medulla. Adrenocortical carcinoma develops in the cortex, which produces hormones such as cortisol, aldosterone, and certain sex hormones.

Some tumors produce excessive amounts of hormones, while others do not. The cancer may remain within the adrenal gland initially, but advanced disease can spread to nearby tissues or distant organs, including the liver and lungs.

Although this cancer is uncommon, early medical assessment is important when symptoms or test results suggest a possible adrenal tumor.

What Are the Symptoms of Adrenocortical Carcinoma?

Symptoms can differ depending on the tumor's size, location, and hormone production. Some people may not notice clear symptoms during the early stages.

Common warning signs include:

Unexplained weight gain: Excess cortisol may cause weight gain, especially around the abdomen and face.

Muscle weakness: High cortisol levels can weaken muscles, particularly those in the arms and legs.

High blood pressure: Some tumors produce excess aldosterone, which can raise blood pressure and lower potassium levels.

Changes in body hair or menstrual cycles: Excess androgen or estrogen production may cause unusual hair growth, irregular periods, or other hormonal changes.

Early puberty in children: Hormone-producing tumors may cause puberty to begin earlier than expected.

Abdominal or back pain: A growing tumor may press against nearby tissues.

A lump or feeling of fullness: Larger tumors may cause abdominal swelling or discomfort.

These symptoms can occur for many reasons and do not automatically mean someone has cancer. However, persistent or unexplained changes should be discussed with a healthcare professional.

What Causes Adrenocortical Carcinoma?

The exact cause of most cases is not known. Cancer develops when cells acquire changes that allow them to grow and divide without normal control.

Certain inherited conditions can increase the risk of developing this cancer. These include Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, and familial adenomatous polyposis.

However, many people diagnosed with adrenocortical carcinoma have no known family history or inherited condition. A doctor or genetic counselor may recommend genetic assessment when the patient's age, family history, or other findings suggest an inherited risk.

How Is Adrenocortical Carcinoma Diagnosed?

Doctors use several tests to examine the adrenal gland, check hormone levels, and determine whether a tumor may be cancerous.

Medical History and Physical Examination

The doctor may ask about symptoms, medication use, family history, and changes in weight, blood pressure, or hormone-related features. A physical examination can help identify signs of excess hormone production.

Blood and Urine Tests

Blood and urine tests can measure hormone levels and look for unusual hormone production. These tests may include measurements related to cortisol, aldosterone, and other adrenal hormones.

The results help doctors understand how the tumor may be affecting the body, but hormone tests alone cannot confirm cancer.

Imaging Tests

CT scans and MRI scans can show the tumor's size, location, and appearance. These scans also help doctors check whether the cancer may have spread to nearby tissues or other organs.

Biopsy and Further Testing

A biopsy is not always the first step when doctors suspect adrenocortical carcinoma. In some cases, removing the tumor without first taking a tissue sample is preferred. A specialist team decides the safest approach based on imaging and other findings.

After surgery, laboratory examination of the tumor can help confirm the diagnosis and determine important features of the cancer.

What Are the Treatment Options?

Treatment depends on the tumor's size, whether it has spread, hormone production, and the patient's overall health.

Surgery

Surgery is the main treatment for many localized adrenocortical carcinomas. The goal is to remove the tumor completely when possible. Some patients may also need nearby tissue removed, depending on the extent of the disease.

Medication

Mitotane is a medicine used to treat adrenocortical carcinoma in selected situations. It may be prescribed after surgery when the risk of recurrence is high or to treat advanced disease. It requires careful monitoring because it can cause side effects and affect hormone levels.

Chemotherapy and Radiation Therapy

Chemotherapy may be recommended when the cancer has spread, cannot be fully removed, or has returned. Radiation therapy may be considered in certain cases, including selected situations after surgery or when treating specific areas of disease.

Hormone Management

Tumors that produce excessive hormones may require medicines to control hormone levels. Patients may also need hormone replacement after surgery if their adrenal glands cannot produce enough essential hormones.

A team that includes endocrine specialists, cancer doctors, and surgeons can help determine the most suitable treatment plan.

Can Adrenocortical Carcinoma Be Prevented?

There is no proven way to prevent most cases because the exact cause is often unknown. People with certain inherited conditions may benefit from genetic counseling and a specialist-recommended monitoring plan.

Seeking medical advice for persistent symptoms and following recommended care for known hereditary conditions can help identify health problems that need further investigation.

FAQs

Is adrenocortical carcinoma a serious cancer?

Yes. It can be aggressive, particularly when diagnosed at an advanced stage. However, outcomes vary depending on the stage, tumor characteristics, and response to treatment.

Can adrenocortical carcinoma cause hormonal changes?

Yes. Some tumors produce excess cortisol, aldosterone, androgens, or estrogens. These changes may affect weight, blood pressure, muscle strength, menstrual cycles, or physical development.

Can this cancer be cured?

Some localized tumors can be treated successfully with complete surgical removal. Advanced or recurrent disease can be more difficult to treat, so the outlook depends on individual circumstances.

Which doctor treats adrenocortical carcinoma?

An endocrinologist may evaluate hormone-related symptoms, while a medical oncologist and an experienced adrenal surgeon may manage cancer treatment. Care often involves several specialists.

Conclusion

Adrenocortical carcinoma is a rare cancer that develops in the outer layer of the adrenal glands. It may cause abdominal discomfort, unexplained physical changes, high blood pressure, or symptoms related to excess hormone production.

Blood and urine tests, imaging, and examination of tumor tissue can help doctors establish a diagnosis. Surgery is often the main treatment for localized disease, while medicines, chemotherapy, radiation therapy, and hormone management may be used in selected cases.