Adrenal carcinoma history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
== History and Symptoms == | |||
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]]. <ref name="DeVita">{{cite book |author=edited by Vincent T. DeVita, Samuel Hellman, Steven A. Rosenberg |title=Cancer: principles & practice of oncology |publisher=Lippincott-Raven |location=Philadelphia |year=2005 |pages= |isbn=0-7817-4865-8 |oclc= |doi=}}</ref> 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.<ref name="UTDACC">{{cite web | last =Savarese | first =Diane MF | coauthors =Lynnette K Nieman| title =Clinical presentation and evaluation of adrenocortical tumors| work =UpToDate Online v. 15.1| publisher =UpToDate| date = August 8, 2006| url =http://www.uptodateonline.com/utd/content/topic.do?topicKey=adrenal/17707&type=A&selectedTitle=1~16 | accessdate =June 5, 2007}}</ref> | |||
All patients with suspected adrenocortical carcinoma should be carefully evaluated for signs and symptoms of hormonal syndromes. For Cushing's syndrome ([[glucocorticoid]] excess) these include [[weight gain]], [[muscle wasting]], purple lines on the abdomen, a fatty [[buffalo hump|"buffalo hump"]] on the neck, a [[moon face|"moonlike" face]], and thinning, fragile skin. 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]]. [[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]]. [[Feminization]] ([[estrogen]] excess) is most readily noted in men, and includes [[gynecomastia|breast enlargement]], decreased [[libido]] and [[impotence]].<ref name="DeVita"/><ref name="UTDACC"/><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> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
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[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Medicine]] | |||
[[Category:Endocrinology]] | |||
[[Category:Surgery]] | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History and Symptoms
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. [1] 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 catecholamines has been reported in adrenocortical cancers.[2] Non-functional tumors (about 40%, authorities vary) usually present with abdominal or flank pain, or they may be asymptomatic and detected incidentally.[3]
All patients with suspected adrenocortical carcinoma should be carefully evaluated for signs and symptoms of hormonal syndromes. For Cushing's syndrome (glucocorticoid excess) these include weight gain, muscle wasting, purple lines on the abdomen, a fatty "buffalo hump" on the neck, a "moonlike" face, and thinning, fragile skin. Virilism (androgen excess) is most obvious in women, and may produce excess facial and body hair, acne, enlargement of the clitoris, deepening of the voice, coarsening of facial features, and cessation of menstruation. 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. Feminization (estrogen excess) is most readily noted in men, and includes breast enlargement, decreased libido and impotence.[1][3][4]
References
- ↑ 1.0 1.1 edited by Vincent T. DeVita, Samuel Hellman, Steven A. Rosenberg (2005). Cancer: principles & practice of oncology. Philadelphia: Lippincott-Raven. ISBN 0-7817-4865-8.
- ↑ Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor). Modern Surgical Pathology (2 Volume Set). London: W B Saunders. ISBN 0-7216-7253-1.
- ↑ 3.0 3.1 Savarese, Diane MF (August 8, 2006). "Clinical presentation and evaluation of adrenocortical tumors". UpToDate Online v. 15.1. UpToDate. Retrieved June 5, 2007. Unknown parameter
|coauthors=ignored (help) - ↑ 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