Adrenocortical carcinoma history and symptoms: Difference between revisions

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{{Adrenocortical carcinoma}}
{{Adrenocortical carcinoma}}
{{CMG}}; {{AE}} {{RT}}
{{CMG}}; {{AE}} {{RT}} {{AAM}} {{MAD}}
==Overview==
Symptoms of [[adrenocortical carcinoma]] include symptoms of [[androgen]], [[glucocorticoid]], [[mineralocorticoid]], or [[estrogen]] excess. Symptoms of [[glucocorticoid]] excess include [[Weight gain]], [[Acne]], irritability. Symptoms of [[androgen]] excess include [[hirsuitism|hirsutism]], [[Irritability|acne]], and [[Irritability|deepening of the voice.]] Symptoms [[Irritability|of]] [[mineralcorticoid|mineralocorticoid]] excess include [[headache]], [[Muscle weakness|muscle weakness,]] [[Confusion]], and [[Palpitations|palpitations.]]
==Common Symptoms==
60 percent of [[adrenocortical carcinoma]] (ACC) are sufficiently secretory to present clinical syndrome of hormone excess.<ref name="pmid16551738">{{cite journal| author=Allolio B, Fassnacht M| title=Clinical review: Adrenocortical carcinoma: clinical update. | journal=J Clin Endocrinol Metab | year= 2006 | volume= 91 | issue= 6 | pages= 2027-37 | pmid=16551738 | doi=10.1210/jc.2005-2639 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16551738  }}</ref>
* 45% of ACCs show symptoms of [[Cushing's syndrome]] alone.
* 25% present with mixed overproduction of both [[glucocorticoids]] and [[androgens]]. <ref name="pmid10679640">{{cite journal| author=Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA et al.| title=Adrenocortical carcinoma: clinical and laboratory observations. | journal=Cancer | year= 2000 | volume= 88 | issue= 4 | pages= 711-36 | pmid=10679640 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10679640  }}</ref>
* 10% present with [[virilization]] alone.
1- Symptoms of [[glucocorticoid]] excess include: <ref>{{Cite journal
 
| author = [[Bibek Bista]] & [[Nancy Beck]]
| title = Cushing syndrome
| journal = [[Indian journal of pediatrics]]
| volume = 81
| issue = 2
| pages = 158–164
| year = 2014
  | doi = 10.1007/s12098-013-1203-8
| pmid = 24062268
}}</ref>
*[[Weight gain]]
*[[Acne]]
*[[Irritability]]
*[[Insomnia]]
 
2- Symptoms of [[androgen]] excess [[symptoms]] in women include: <ref>{{Cite journal
 
| author = [[Lourdes Ibanez]], [[Ken K. Ong]], [[Abel Lopez-Bermejo]], [[David B. Dunger]] & [[Francis de Zegher]]
| title = Hyperinsulinaemic androgen excess in adolescent girls
| journal = [[Nature reviews. Endocrinology]]
| volume = 10
| issue = 8
| pages = 499–508
| year = 2014
| doi = 10.1038/nrendo.2014.58
| pmid = 24776733
}}</ref>
*[[Hirsutism|Excess facial and body hair]]
*[[Acne]]
*Deepening of the voice
*Coarsening of [[facial]] features
*[[Amenorrhea|Cessation of menstruation]]
3- Symptoms of [[mineralcorticoid|mineralocorticoid]] excess include: <ref>{{Cite journal
 
| author = [[Valeria Bisogni]], [[Gian Paolo Rossi]] & [[Lorenzo A. Calo]]
| title = Apparent mineralcorticoid excess syndrome, an often forgotten or unrecognized cause of hypokalemia and hypertension: case report and appraisal of the pathophysiology
| journal = [[Blood pressure]]
| volume = 23
| issue = 3
| pages = 189–192
| year = 2014
| doi = 10.3109/08037051.2013.832967
| pmid = 24053336
}}</ref>
*[[Headache]]
*[[Muscle weakness]]
*[[Confusion]]
*[[Palpitations]]
4- Symptoms of [[estrogen]] excess in men include: <ref>{{Cite journal


==Overview==
| author = [[G. M. Zanetta]], [[M. J. Webb]], [[H. Li]] & [[G. L. Keeney]]
| title = Hyperestrogenism: a relevant risk factor for the development of cancer from endometriosis
| journal = [[Gynecologic oncology]]
| volume = 79
| issue = 1
| pages = 18–22
| year = 2000
| doi = 10.1006/gyno.2000.5905
| pmid = 11006024
}}</ref>
*[[Gynecomastia]]
*Decreased [[libido]]
*[[Impotence]]


== History and Symptoms ==
5- Symptoms of [[catecholamine]]s excess has been reported in adrenocortical cancers: <ref name="Weidner's">{{cite book |author=Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) |title=Modern Surgical Pathology (2 Volume Set) |publisher=W B Saunders |location=London |year= |pages= |isbn=0-7216-7253-1 |oclc= |doi=}}</ref>
Adrenocortical carcinoma may present differently in children and adults.  Most tumors in children are functional, and [[virilization]] is by far the most common presenting symptom, followed by [[Cushing's syndrome]] and [[precocious puberty]].  Among adults presenting with hormonal syndromes, Cushing's syndrome alone is most common, followed by mixed Cushing's and virilization ([[glucocorticoid]] and [[androgen]] overproduction). [[Feminization]] and [[Conn syndrome]] ([[mineralcorticoid]] excess) occur in less than 10% of cases.  Rarely, [[pheochromocytoma]]-like hypersecretion of [[catecholamine]]s has been reported in adrenocortical cancers.<ref name="Weidner's">{{cite book |author=Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) |title=Modern Surgical Pathology (2 Volume Set) |publisher=W B Saunders |location=London |year= |pages= |isbn=0-7216-7253-1 |oclc= |doi=}}</ref> Non-functional tumors (about 40%, authorities vary) usually present with abdominal or flank pain, or they may be asymptomatic and detected incidentally.
*[[Headache]]
*[[Sweating]]
*[[Palpitation]]


All patients with suspected adrenocortical carcinoma should be carefully evaluated for signs and symptoms of hormonal syndromes. For:  
6- Other symptoms may include: <ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/adrenocortical/patient/adrenocortical-treatment-pdq#section/_1</ref>
* Cushing's syndrome ([[glucocorticoid]] excess) these include [[weight gain]], [[muscle wasting]], purple lines on the abdomen, a fatty "buffalo hump" on the neck, a [[moon face|"moonlike" face]], and thinning, fragile skin.
*[[Abdominal mass|Abdominal lump]]
* Virilism ([[androgen]] excess) is most obvious in women, and may produce [[hirsutism|excess facial and body hair]], [[acne]], enlargement of the [[clitoris]], deepening of the voice, coarsening of facial features, and [[amenorrhea|cessation of menstruation]].
*[[Abdominal]] or [[back pain]]
* [[Conn syndrome]] ([[mineralcorticoid]] excess) is marked by [[high blood pressure]], which can result in [[headache]], and [[hypokalemia]] (low serum potassium), which can produce muscle weakness, confusion, and [[palpitations]].  Low plasma [[renin]] activity, and high serum [[aldosterone]].
*[[Abdominal]] fullness
* [[Feminization]] ([[estrogen]] excess) is most readily noted in men, and includes [[gynecomastia|breast enlargement]], decreased [[libido]] and [[impotence]].<ref>Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL. ''Harrison's Principles of Internal Medicine''. New York: McGraw-Hill, 2005. ISBN 0-07-139140-1</ref>
7- Children usually present with [[virilization]] (84%), while isolated [[glucocorticoid]] excess is much less common (6%). <ref name="pmid15137014">{{cite journal| author=Stewart JN, Flageole H, Kavan P| title=A surgical approach to adrenocortical tumors in children: the mainstay of treatment. | journal=J Pediatr Surg | year= 2004 | volume= 39 | issue= 5 | pages= 759-63 | pmid=15137014 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15137014  }}</ref>


==References==
==References==
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Latest revision as of 18:58, 30 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Ahmad Al Maradni, M.D. [3] Mohammed Abdelwahed M.D[4]

Overview

Symptoms of adrenocortical carcinoma include symptoms of androgen, glucocorticoid, mineralocorticoid, or estrogen excess. Symptoms of glucocorticoid excess include Weight gain, Acne, irritability. Symptoms of androgen excess include hirsutism, acne, and deepening of the voice. Symptoms of mineralocorticoid excess include headache, muscle weakness, Confusion, and palpitations.

Common Symptoms

60 percent of adrenocortical carcinoma (ACC) are sufficiently secretory to present clinical syndrome of hormone excess.[1]

1- Symptoms of glucocorticoid excess include: [3]

2- Symptoms of androgen excess symptoms in women include: [4]

3- Symptoms of mineralocorticoid excess include: [5]

4- Symptoms of estrogen excess in men include: [6]

5- Symptoms of catecholamines excess has been reported in adrenocortical cancers: [7]

6- Other symptoms may include: [8]

7- Children usually present with virilization (84%), while isolated glucocorticoid excess is much less common (6%). [9]

References

  1. ↑ Allolio B, Fassnacht M (2006). "Clinical review: Adrenocortical carcinoma: clinical update". J Clin Endocrinol Metab. 91 (6): 2027–37. doi:10.1210/jc.2005-2639. PMID 16551738.
  2. ↑ Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA; et al. (2000). "Adrenocortical carcinoma: clinical and laboratory observations". Cancer. 88 (4): 711–36. PMID 10679640.
  3. ↑ Bibek Bista & Nancy Beck (2014). "Cushing syndrome". Indian journal of pediatrics. 81 (2): 158–164. doi:10.1007/s12098-013-1203-8. PMID 24062268.
  4. ↑ Lourdes Ibanez, Ken K. Ong, Abel Lopez-Bermejo, David B. Dunger & Francis de Zegher (2014). "Hyperinsulinaemic androgen excess in adolescent girls". Nature reviews. Endocrinology. 10 (8): 499–508. doi:10.1038/nrendo.2014.58. PMID 24776733.
  5. ↑ Valeria Bisogni, Gian Paolo Rossi & Lorenzo A. Calo (2014). "Apparent mineralcorticoid excess syndrome, an often forgotten or unrecognized cause of hypokalemia and hypertension: case report and appraisal of the pathophysiology". Blood pressure. 23 (3): 189–192. doi:10.3109/08037051.2013.832967. PMID 24053336.
  6. ↑ G. M. Zanetta, M. J. Webb, H. Li & G. L. Keeney (2000). "Hyperestrogenism: a relevant risk factor for the development of cancer from endometriosis". Gynecologic oncology. 79 (1): 18–22. doi:10.1006/gyno.2000.5905. PMID 11006024.
  7. ↑ Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor). Modern Surgical Pathology (2 Volume Set). London: W B Saunders. ISBN 0-7216-7253-1.
  8. ↑ National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/adrenocortical/patient/adrenocortical-treatment-pdq#section/_1
  9. ↑ Stewart JN, Flageole H, Kavan P (2004). "A surgical approach to adrenocortical tumors in children: the mainstay of treatment". J Pediatr Surg. 39 (5): 759–63. PMID 15137014.
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