Adrenocortical carcinoma: role of laparoscopic surgery in treatment

Adrenocortical carcinoma is a rare disorder with a prevalence of one case per 1.7 million people and a generally poor prognosis. It accounts for 0.02% of all cancer cases and 0.2% of cancer deaths. Within the past three decades, accurate diagnosis, precise radiologic localization, satisfactory preoperative medical management, appropriate anesthesia and refined surgical techniques have come together to render the surgical management of adrenal abnormalities a safe endeavor with predictable outcomes. While there is a general agreement on the suitability of the laparoscopic approach for benign adrenal lesions, controversy remains regarding the use of laparoscopy for suspected adrenal malignancies. This paper provides an overview of adrenal cancer and reviews the literature on laparoscopic adrenalectomy for cancer, including the operative techniques, indications and contraindications.