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    Adrenocortical carcinoma

    Tumor - adrenal; ACC - adrenal

    Adrenocortical carcinoma (ACC) is a cancer of the adrenal glands. The adrenal glands are two triangle-shaped glands. One gland is located on top of each kidney.

    Causes

    ACC is most common in children younger than 5 years old and adults in their 40s and 50s.

    The condition may be linked to a cancer syndrome that is passed down through families (inherited). Both men and women can develop this tumor.

    ACC can produce the hormones cortisol, aldosterone, estrogen, or testosterone, as well as other hormones. In women the tumor often releases these hormones, which can lead to male characteristics.

    ACC is very rare. The cause is unknown.

    Symptoms

    Symptoms of increased cortisol or other adrenal gland hormones may include:

    • Fatty, rounded hump high on the back just below the neck (buffalo hump)
    • Flushed, rounded face with pudgy cheeks (moon face)
    • Obesity
    • Stunted growth (short stature)
    • Virilization -- the appearance of male characteristics, including increased body hair (especially on the face), pubic hair, acne, deepening of the voice, and enlarged clitoris (females)

    Symptoms of increased aldosterone are the same as symptoms of low potassium, and include:

    • Muscle cramps
    • Weakness
    • Pain in the abdomen

    Exams and Tests

    Your health care provider will perform a physical exam and ask about your symptoms.

    Blood tests will be done to check hormone levels:

    • ACTH level will be low.
    • Aldosterone level will be high.
    • Cortisol level will be high.
    • Potassium level will be low.
    • Male or female hormones may be abnormally high.

    Imaging tests of the abdomen may include:

    Treatment

    The primary treatment is surgery to remove the tumor. ACC may not improve with chemotherapy. Medicines may be given to reduce production of cortisol, which causes many of the symptoms.

    Outlook (Prognosis)

    The outcome depends on how early the diagnosis is made and whether the tumor has spread (metastasized). Tumors that have spread usually lead to death within 1 to 3 years.

    Possible Complications

    The tumor can spread to the liver, bone, lung, or other areas.

    When to Contact a Medical Professional

    Contact your provider if you or your child has symptoms of ACC, Cushing syndrome, or failure to grow.

    Open References

    References

    Habra M, Else T, Fassnacht M. Adrenocortical carcinoma. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 98.

    National Cancer Institute website. Adrenocortical carcinoma treatment (PDQ) - health professional version. www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq. Updated August 25, 2022. Accessed August 27, 2024.

    Yeh MW, Livhits M, Duh Q-Y. The adrenal glands. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, et al, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 40.

      • Endocrine glands

        Endocrine glands - illustration

        Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

        Endocrine glands

        illustration

      • Adrenal metastases - CT scan

        Adrenal metastases - CT scan - illustration

        This CT scan of the upper abdomen shows an adrenal metastasis (spreading of a tumor to the adrenal gland, above the kidney) in a person with lung cancer.

        Adrenal metastases - CT scan

        illustration

      • Adrenal Tumor - CT

        Adrenal Tumor - CT - illustration

        CT scan of the upper abdomen in a person with a right adrenal mass. The adrenal glands are located above the kidneys.

        Adrenal Tumor - CT

        illustration

        • Endocrine glands

          Endocrine glands - illustration

          Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

          Endocrine glands

          illustration

        • Adrenal metastases - CT scan

          Adrenal metastases - CT scan - illustration

          This CT scan of the upper abdomen shows an adrenal metastasis (spreading of a tumor to the adrenal gland, above the kidney) in a person with lung cancer.

          Adrenal metastases - CT scan

          illustration

        • Adrenal Tumor - CT

          Adrenal Tumor - CT - illustration

          CT scan of the upper abdomen in a person with a right adrenal mass. The adrenal glands are located above the kidneys.

          Adrenal Tumor - CT

          illustration

        Review Date: 8/21/2024

        Reviewed By: Warren Brenner, MD, Oncologist, Lynn Cancer Institute, Boca Raton, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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