Adrenocortical carcinoma natural history: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 6: | Line 6: | ||
==Complications== | ==Complications== | ||
The following are the complications of [[Adrenocortical carcinoma]]: | The following are the complications of [[Adrenocortical carcinoma]]: | ||
* [[Cushing's syndrome]] | * [[Cushing's syndrome]]-relayed complications | ||
* [[ | * [[Hyperglycemia]] | ||
* [[Diabetes mellitus]] | |||
* [[Osteoporosis]] | |||
* Delayed [[wound healing]] | |||
* [[Hypertension]] | * [[Hypertension]] | ||
* [[Myocardial infarction]] | |||
* [[Cerebrovascular disease]] | |||
* [[Hypercoagulable state]] | |||
* [[Conn's syndrome]] | |||
* Local and distant [[metastasis]] | * Local and distant [[metastasis]] | ||
* [[Metastases]] to the [[Liver|liver,]] [[lungs]], or [[Lymph node|lymph nodes]] can be seen, and invasion of adjacent organs or venous extension into the renal vein and [[inferior vena cava]] may be present.<sup>[[Adrenocortical carcinoma pathophysiology#cite note-pmid7142516-2|[2]]]</sup> | |||
* [[Inferior vena cava]] invasion has been reported in 9% to 19% of cases at presentation.<sup>[[Adrenocortical carcinoma pathophysiology#cite note-pmid21606258-3|[3]]]</sup> | |||
* [[Paraneoplastic syndrome]] | * [[Paraneoplastic syndrome]] | ||
* Tumor [[thrombus]] formation | * a set of signs and symptoms that is the consequence of cancer in the body, but unlike mass effect, is not due to the local presence of cancer cells. | ||
* In contrast, these phenomena are mediated by humoral factors (such as hormones or cytokines) excreted by tumor cells or by an immune response against the tumor. | |||
* [[Tumor]] [[thrombus]] formation | |||
==Prognosis== | ==Prognosis== | ||
| Line 19: | Line 30: | ||
The most important prognostic factors are: | The most important prognostic factors are: | ||
* Age of the patient ( | * Age of the patient<ref name="pmid26392430">{{cite journal| author=Libé R, Borget I, Ronchi CL, Zaggia B, Kroiss M, Kerkhofs T et al.| title=Prognostic factors in stage III-IV adrenocortical carcinomas (ACC): an European Network for the Study of Adrenal Tumor (ENSAT) study. | journal=Ann Oncol | year= 2015 | volume= 26 | issue= 10 | pages= 2119-25 | pmid=26392430 | doi=10.1093/annonc/mdv329 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26392430 }}</ref> | ||
* Stage of the tumor | * Stage of the tumor<ref name="pmid18063070">{{cite journal| author=Gonzalez RJ, Tamm EP, Ng C, Phan AT, Vassilopoulou-Sellin R, Perrier ND et al.| title=Response to mitotane predicts outcome in patients with recurrent adrenal cortical carcinoma. | journal=Surgery | year= 2007 | volume= 142 | issue= 6 | pages= 867-75; discussion 867-75 | pmid=18063070 | doi=10.1016/j.surg.2007.09.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18063070 }}</ref> | ||
* Mitotic activity | * Mitotic activity<ref name="pmid20694732">{{cite journal| author=Miller BS, Gauger PG, Hammer GD, Giordano TJ, Doherty GM| title=Proposal for modification of the ENSAT staging system for adrenocortical carcinoma using tumor grade. | journal=Langenbecks Arch Surg | year= 2010 | volume= 395 | issue= 7 | pages= 955-61 | pmid=20694732 | doi=10.1007/s00423-010-0698-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20694732 }}</ref> | ||
* Venous invasion | * Venous invasion | ||
* Weight more than 50 Kg | * Weight more than 50 Kg | ||
* Diameter more than 6.5 cm | * Diameter more than 6.5 cm | ||
* Cortisol production as an adverse prognostic factor | * Cortisol production as an adverse prognostic factor | ||
* Ki-67/MIB1 labeling index (antigen identified by monoclonal antibody Ki-67) | * Ki-67/MIB1 labeling index (antigen identified by monoclonal antibody Ki-67) | ||
* Survival ranges from a few months to several years. | * Survival ranges from a few months to several years<ref name="pmid18505909">{{cite journal| author=Hermsen IG, Gelderblom H, Kievit J, Romijn JA, Haak HR| title=Extremely long survival in six patients despite recurrent and metastatic adrenal carcinoma. | journal=Eur J Endocrinol | year= 2008 | volume= 158 | issue= 6 | pages= 911-9 | pmid=18505909 | doi=10.1530/EJE-07-0723 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18505909 }}</ref> | ||
==References== | ==References== | ||
Revision as of 19:49, 22 September 2017
|
Adrenocortical carcinoma Microchapters |
|
Differentiating Adrenocortical carcinoma from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Study |
|
Adrenocortical carcinoma natural history On the Web |
|
American Roentgen Ray Society Images of Adrenocortical carcinoma natural history |
|
Risk calculators and risk factors for Adrenocortical carcinoma natural history |
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]
Overview
Prognosis is generally poor, and the 5-year survival rate of patients with adrenocortical carcinoma stage I-III is approximately 30%. Complication may include metastasis, Conn syndrom and Cushing syndrom
Complications
The following are the complications of Adrenocortical carcinoma:
- Cushing's syndrome-relayed complications
- Hyperglycemia
- Diabetes mellitus
- Osteoporosis
- Delayed wound healing
- Hypertension
- Myocardial infarction
- Cerebrovascular disease
- Hypercoagulable state
- Conn's syndrome
- Local and distant metastasis
- Metastases to the liver, lungs, or lymph nodes can be seen, and invasion of adjacent organs or venous extension into the renal vein and inferior vena cava may be present.[2]
- Inferior vena cava invasion has been reported in 9% to 19% of cases at presentation.[3]
- Paraneoplastic syndrome
- a set of signs and symptoms that is the consequence of cancer in the body, but unlike mass effect, is not due to the local presence of cancer cells.
- In contrast, these phenomena are mediated by humoral factors (such as hormones or cytokines) excreted by tumor cells or by an immune response against the tumor.
- Tumor thrombus formation
Prognosis
Adrenocortical carcinoma, generally, carries a poor prognosis.[1]
The five-year disease-free survival rate for a complete resection of a stage I-III is approximately 30%.[1]
The most important prognostic factors are:
- Age of the patient[2]
- Stage of the tumor[3]
- Mitotic activity[4]
- Venous invasion
- Weight more than 50 Kg
- Diameter more than 6.5 cm
- Cortisol production as an adverse prognostic factor
- Ki-67/MIB1 labeling index (antigen identified by monoclonal antibody Ki-67)
- Survival ranges from a few months to several years[5]
References
- ↑ 1.0 1.1 Allolio B, Fassnacht M (2006). "Clinical review: Adrenocortical carcinoma: clinical update". J Clin Endocrinol Metab. 91 (6): 2027–37. PMID 16551738. Free Full Text.
- ↑ Libé R, Borget I, Ronchi CL, Zaggia B, Kroiss M, Kerkhofs T; et al. (2015). "Prognostic factors in stage III-IV adrenocortical carcinomas (ACC): an European Network for the Study of Adrenal Tumor (ENSAT) study". Ann Oncol. 26 (10): 2119–25. doi:10.1093/annonc/mdv329. PMID 26392430.
- ↑ Gonzalez RJ, Tamm EP, Ng C, Phan AT, Vassilopoulou-Sellin R, Perrier ND; et al. (2007). "Response to mitotane predicts outcome in patients with recurrent adrenal cortical carcinoma". Surgery. 142 (6): 867–75, discussion 867-75. doi:10.1016/j.surg.2007.09.006. PMID 18063070.
- ↑ Miller BS, Gauger PG, Hammer GD, Giordano TJ, Doherty GM (2010). "Proposal for modification of the ENSAT staging system for adrenocortical carcinoma using tumor grade". Langenbecks Arch Surg. 395 (7): 955–61. doi:10.1007/s00423-010-0698-y. PMID 20694732.
- ↑ Hermsen IG, Gelderblom H, Kievit J, Romijn JA, Haak HR (2008). "Extremely long survival in six patients despite recurrent and metastatic adrenal carcinoma". Eur J Endocrinol. 158 (6): 911–9. doi:10.1530/EJE-07-0723. PMID 18505909.