Adrenal Cortical Cancer

Adrenocortical cancer is one of the rare ; yet most aggressive endocrine malignancy. Commonly seen at extreme of ages. Common presentation of adrenal cortical cancers includes

• Tumours with functionality
• Features of Cushing syndrome
• Feature of Feminism in male patients
• Virilization among female patients
• Non functional tumours detected incidentally
• Non functional tumours with compressive features like Inferior Vena cava obstruction etc.

Preoperative CECT with washout studies has got good sensitivity in picking up adrenal cancer. Hormonal evaluation includes work up for Cushing syndrome, Pheochromocytoma and Hyperandrogenism. Surgery is the first line of treatment for these tumours.Both open and Minimal invasive Adrenalectomy can be considered in management.Usually tumours upto 6cm are treated with minimal access approach whereas larger tumours are better resected by open methods.
Adjuvant Therapies includes Chemotherapy, Radiotherapy and Mitotane; however adjuvant therapies have not shown promising response.