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Adrenocortical carcinoma--our experience with 11 cases
P Langer1, D Bartsch, E Moebius
1Department of General Surgery, Philipps-University Marburg, Germany. langerp@post.med.uni-marburg.de
Langenbeck'S Archives of Surgery
|December 29, 2000
Summary
Radical surgery offers the best chance for cure in adrenocortical carcinoma (ACC). Preoperative venography is crucial for detecting tumor thrombi, aiding surgical planning for this rare cancer.
Area of Science:
- Endocrinology
- Surgical Oncology
- Oncology
Background:
- Adrenocortical carcinoma (ACC) is a rare endocrine malignancy with typically delayed diagnosis and poor prognosis.
- Incidence is approximately 0.5-2 cases per million annually.
- This study reviews experiences with 11 ACC patients treated over 10 years.
Purpose of the Study:
- To evaluate clinical presentation, diagnostic methods, surgical treatment, and outcomes in adrenocortical carcinoma patients.
- To highlight the importance of surgical management and diagnostic imaging in ACC.
Main Methods:
- Retrospective review of 11 patients diagnosed with ACC.
- Evaluation of presenting symptoms, diagnostic procedures, surgical interventions, and follow-up data.
- Surgical procedures included adrenalectomy, resection of recurrence, and liver metastasis resection.
Main Results:
- The study included 8 women and 3 men (mean age 40.2 years).
- Presentations included Cushing's syndrome (6), virilism/hirsutism (2), and hormonally inactive tumors (3).
- Five patients (45%) survived, with 3 disease-free, while 6 patients (55%) died within a median of 10 months post-surgery.
Conclusions:
- Preoperative venography is recommended to identify thrombotic masses in major veins.
- Radical surgery is the primary curative treatment for resectable ACC, including recurrent cases.
- Adjuvant therapy lacks consensus; multidisciplinary approaches require further investigation in multicenter trials.