Adrenocortical carcinoma surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
*Surgery is the mainstay of treatment for adrenocortical carcinoma. | *Surgery is the mainstay of treatment for adrenocortical carcinoma. | ||
*Surgery can also be performed even in the case of invasion into large blood | *Surgery can also be performed even in the case of the invasion into large blood vessels, such as the [[renal vein]] or [[inferior vena cava]]. | ||
* | *A large percentage of patients are not surgical candidates. | ||
Appropriate preoperative evaluation and operative planning | Appropriate preoperative evaluation and operative planning are the most important to assure the best outcome. | ||
Preoperative imaging should be obtained to evaluate the extent | Preoperative imaging should be obtained to evaluate the extent of the tumor. | ||
Imaging should be done just before the surgery because ACC grow quickly and involvement of adjacent structures may change | |||
Optimization of hormone excess in patients with functional masses especially those with Cushing’s syndrome | |||
Patients widespread distant metastatic disease in multiple organs or those with multiple metastatic deposits in one organ system unable to be completely resected should not undergo adrenalectomy. | |||
The primary tumor can instead be treated with external beam radiation for palliation along with other adjuncts to improve local symptoms and better control hormone excess, | |||
if present (247). | |||
Obstruction of the vena cava by tumor thrombus can lead to significant lower body edema, which leads to significant patient suffering. If tumor resection is not technically operable, vena cava stents can be placed, leading to temporary prevention of occlusion. | |||
Debulking for control of hormone excess in the setting of known metastatic disease is also performed in some situations. The benefits of debulking must outweigh the risks of surgery in these patients who have poor wound healing and lengthy recovery periods due to preexisting debilitation | |||
==References== | ==References== | ||
Revision as of 14:50, 21 September 2017
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Adrenocortical carcinoma Microchapters |
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Differentiating Adrenocortical carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Study |
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Adrenocortical carcinoma surgery On the Web |
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American Roentgen Ray Society Images of Adrenocortical carcinoma surgery |
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Risk calculators and risk factors for Adrenocortical carcinoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Overview
Surgery is the mainstay of treatment for adrenocortical carcinoma.
Surgery
- Surgery is the mainstay of treatment for adrenocortical carcinoma.
- Surgery can also be performed even in the case of the invasion into large blood vessels, such as the renal vein or inferior vena cava.
- A large percentage of patients are not surgical candidates.
Appropriate preoperative evaluation and operative planning are the most important to assure the best outcome.
Preoperative imaging should be obtained to evaluate the extent of the tumor.
Imaging should be done just before the surgery because ACC grow quickly and involvement of adjacent structures may change
Optimization of hormone excess in patients with functional masses especially those with Cushing’s syndrome
Patients widespread distant metastatic disease in multiple organs or those with multiple metastatic deposits in one organ system unable to be completely resected should not undergo adrenalectomy.
The primary tumor can instead be treated with external beam radiation for palliation along with other adjuncts to improve local symptoms and better control hormone excess,
if present (247).
Obstruction of the vena cava by tumor thrombus can lead to significant lower body edema, which leads to significant patient suffering. If tumor resection is not technically operable, vena cava stents can be placed, leading to temporary prevention of occlusion.
Debulking for control of hormone excess in the setting of known metastatic disease is also performed in some situations. The benefits of debulking must outweigh the risks of surgery in these patients who have poor wound healing and lengthy recovery periods due to preexisting debilitation