Adrenocortical carcinoma (ACC) is a rare and complex form of Adrenal cancer where the malignant cells originate in the adrenal glands. The adrenal glands are vital organs located right above the kidneys and are responsible for hormone production. This malignancy arises from the cortex, the outer layer of the adrenal glands, where hormones like cortisol and aldosterone are synthesized.
Known for its rarity and multifaceted nature, ACC presents unique challenges in diagnosis and treatment, often requiring a specialized approach due to its potential to produce excess hormones, leading to various symptoms. 
Also Read: Adrenal Cancer: Causes, Symptoms And Treatment
The prognosis for adrenocortical carcinoma depends on various factors, including the stage at diagnosis, the tumour size, and whether it has spread. Early detection and complete surgical removal offer the best chance for a favourable outcome. However, ACC is often diagnosed at an advanced stage, making it more challenging to treat.
Causes
The exact cause of adrenocortical carcinoma is unknown. However, some medical studies show that it usually occurs when there is a genetic change in the cells of the adrenal glands, causing them to divide and grow uncontrollably in size and number. This leads to the production of a huge number of abnormal cells that stick together to form tumourous structures.
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Risk Factors
Certain risk factors that may contribute to its development include the following:
Genetic Factors: Inherited genetic syndromes, such as Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, familial adenomatous polyposis (FAP), or Carney complex, are associated with an increased risk of ACC. Mutations in certain genes, including TP53 or APC, can predispose individuals to this rare cancer.
Hereditary Conditions: In some cases, ACC can arise due to hereditary factors. People with a family history of ACC or certain genetic mutations might have a higher likelihood of developing this cancer.
Radiation Exposure: Previous exposure to high levels of radiation, particularly during childhood or as part of radiation therapy for other conditions, has been linked to an increased risk of ACC.
Unknown Factors: In a significant number of cases, the specific cause of ACC remains unidentified. The interplay of genetic predisposition, environmental factors, and potential triggers might contribute to the development of this rare cancer.
Symptoms
The characteristic signs and symptoms of adrenocortical carcinoma include:
- Abdominal pain
- Formation of a mass in the abdomen
- Unintentional weight loss
- Irregular menstrual periods in women
- Excessive hair growth in women (hirsutism)
- Deepening of voice in women
- High blood pressure
- Enlargement of breasts in men
- Shortening of testicles in men
- Reduces hunger
- Weakness or fatigue
- Changes in mood or behaviour due to hormone imbalances
Diagnosis
If you notice any of the above-mentioned signs, consult your doctor as soon as possible. The doctor usually does a thorough examination, acknowledges the patient’s medical and family history and conducts the following diagnostics:
- Imaging Tests: CT scans, MRI, or PET scans are used to visualize the tumour and assess its size and spread.
- Hormone Tests: Blood and urine tests are conducted to measure hormone levels, as ACC often produces excessive hormones.
- Biopsy: A tissue sample may be obtained through a biopsy to confirm the diagnosis by examining the cells under a microscope.
Treatment
Since ACC is a complex and often aggressive cancer, treatment plans are generally managed by a multidisciplinary team of specialists, including endocrinologists, oncologists, surgeons, and other healthcare professionals. The choice of treatment depends on factors such as the stage of cancer, the size and location of the tumour, the patient's overall health, and the presence of metastasis. The available treatment options include:
Surgery: The primary treatment for ACC involves surgical removal of the tumour and affected adrenal glands, if possible.
Chemotherapy: In cases where cancer has spread or surgery isn’t feasible, chemotherapy may be used to shrink the tumour or slow its growth.
Radiation Therapy: This treatment might be employed after surgery to eliminate any remaining cancer cells or for palliative care to relieve symptoms.
Targeted Therapy: Some targeted drugs are being investigated to treat ACC by targeting specific genetic mutations.
Clinical Trials: Participation in clinical trials might be an option, allowing access to newer treatments or combinations of therapies that are being evaluated for their effectiveness against ACC.
Disclaimer:
The content provided here is for informational purposes only. This blog is not intended to substitute for medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions or concerns you may have regarding a medical condition. Reliance does not endorse or recommend any specific tests, physicians, procedures, opinions, or other information mentioned on the blog.
