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==Laboratory Findings==
==Laboratory Findings==
Laboratory findings that may associate adrenocortical carcinoma are:
Laboratory findings that may associate adrenocortical carcinoma are:
Adrenal androgens [DHEAS], androstenedione,  bioavailable testosterone should be measured in every patient.  17-hydroxyprogesterone  serum estradiol in men and postmenopausal women [85].
fasting blood glucose,  serum potassium,  cortisol,  ACTH (10 pg/mL)  24-hour urinary free cortisol,  fasting serum cortisol at 8 AM following a 1 mg dose of dexamethasone at bedtime, 
exclusion of a pheochromocytoma |metanephrine and normetanephrine in plasma or 24-hour urine and mainly serves to prevent unexpected complications during surgery or treatment (96)


* A recent study has shown significant differences in steroid hormone precursor and metabolite profiles in urine of patients with ACC compared with patients with
{| class="wikitable"
benign adrenal tumors (95). This study defined the 11-deoxycortisol metabolite tetrahydro-11-deoxycortisol as the most discriminative marker, although the overall profile of several metabolites provided more information.
!Hormonal disturbance
*  
!labs
Low serum aldosterone concentrations, normal or high serum or urinary concentrations of aldosterone precursors [86,87]
|-
!Cortisol
!
* Cortisol level
* ACTH (10 pg/mL) 
* 24-hour urinary free cortisol
* Fasting serum cortisol at 8 AM following a 1 mg dose of dexamethasone at bedtime
|-
|'''Steroids [85]'''
|
* Adrenal androgens [DHEAS]
* Androstenedione
* Bioavailable testosterone should be measured in every patient. 
* 17-hydroxyprogesterone 
* Serum estradiol in men and postmenopausal women
* A recent study has shown significant differences in steroid hormone precursor and metabolite profiles in urine of patients with ACC compared with patients with benign adrenal tumors (95)
|-
|'''Epinephrine (96)'''
|
* Metanephrine and normetanephrine in plasma or 24-hour urine
|-
|'''Aldosterone [86,87]'''
|
* Low serum aldosterone concentrations, normal or high serum or urinary concentrations of aldosterone precursors  
|}


==References==
==References==

Revision as of 17:25, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

Some patients with adrenocortical carcinoma may have elevated concentration of serum cortisol, aldosterone, testosterone or estrogen and reduced concentration of plasma renin and potassium.

Laboratory Findings

Laboratory findings that may associate adrenocortical carcinoma are:

Hormonal disturbance labs
Cortisol
  • Cortisol level
  • ACTH (10 pg/mL)
  • 24-hour urinary free cortisol
  • Fasting serum cortisol at 8 AM following a 1 mg dose of dexamethasone at bedtime
Steroids [85]
  • Adrenal androgens [DHEAS]
  • Androstenedione
  • Bioavailable testosterone should be measured in every patient.
  • 17-hydroxyprogesterone
  • Serum estradiol in men and postmenopausal women
  • A recent study has shown significant differences in steroid hormone precursor and metabolite profiles in urine of patients with ACC compared with patients with benign adrenal tumors (95)
Epinephrine (96)
  • Metanephrine and normetanephrine in plasma or 24-hour urine
Aldosterone [86,87]
  • Low serum aldosterone concentrations, normal or high serum or urinary concentrations of aldosterone precursors

References

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