Adrenocortical carcinoma CT: Difference between revisions
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:* Differentiating it from other diseases, such as [[adrenocortical adenoma]] | :* Differentiating it from other diseases, such as [[adrenocortical adenoma]] | ||
:* Determining the extent of invasion of the tumor into surrounding organs and tissue | :* Determining the extent of invasion of the tumor into surrounding organs and tissue | ||
*Signs can be detected on CT scan: | *Signs can be detected on CT scan: | ||
**ACCs are large, heterogeneous enhancing masses of soft tissue attenuation. | **ACCs are large, heterogeneous enhancing masses of soft tissue attenuation. | ||
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**Calcifications, which are best detected on CT imaging as high attenuation foci, can be present in approximately30%of cases. These are either coarse calcifications or microcalcifications and usually centrally located. Calcification is also present in other adrenal pathologies such as myelolipoma and 10% of pheochromocytomas and hence is not a distinguishing feature (106). | **Calcifications, which are best detected on CT imaging as high attenuation foci, can be present in approximately30%of cases. These are either coarse calcifications or microcalcifications and usually centrally located. Calcification is also present in other adrenal pathologies such as myelolipoma and 10% of pheochromocytomas and hence is not a distinguishing feature (106). | ||
**Some ACCs may contain areas of intracellular lipid and rarely macroscopic fat resulting in CT density measurements of 10 HU in portions of the tumor (107). | **Some ACCs may contain areas of intracellular lipid and rarely macroscopic fat resulting in CT density measurements of 10 HU in portions of the tumor (107). | ||
**Contrast-enhanced imaging often demonstrates heterogeneous, predominantly irregular peripheral enhancement with central nonenhancing areas secondary to | **Contrast-enhanced imaging often demonstrates heterogeneous, predominantly irregular peripheral enhancement with central nonenhancing areas secondary to hemorrhage or necrosis. Contrast-enhanced CT scan is a reliable method of disease staging, identifying common metastatic sites such as regional and para-aortic lymph nodes, lungs, liver, and bones (98). | ||
hemorrhage or necrosis. Contrast-enhanced CT scan is a reliable method of disease staging, identifying common metastatic sites such as regional and para-aortic lymph nodes, lungs, liver, and bones (98). | |||
**CT imaging of the chest, liver, and bone scan are used for staging workup to detect metastasis. | **CT imaging of the chest, liver, and bone scan are used for staging workup to detect metastasis. | ||
[[File:Non-contrast CT.gif|300px|center|thumb|Non-contrast CT showing ACC with calcifications, source: Case courtesy of Dr Arshdeep Sidhu, Radiopaedia.org, rID: 22048 ct without]] | |||
[[File:CT angiography.gif|300px|center|thumb|CT angiography shows Case courtesy of Radswiki, Radiopaedia.org, rID: 11176 ct with angio]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 13:44, 20 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 CT On the Web |
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American Roentgen Ray Society Images of Adrenocortical carcinoma CT |
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Risk calculators and risk factors for Adrenocortical carcinoma CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2] Mohammed Abdelwahed M.D[3]
Overview
Adrenal CT scan may be helpful in the diagnosis of Adrenocortical carcinoma.
Key CT Findings in adrenocortical carcinoma
- CT scan of the abdomen is useful for:
- Identifying the site of the tumor
- Differentiating it from other diseases, such as adrenocortical adenoma
- Determining the extent of invasion of the tumor into surrounding organs and tissue
- Signs can be detected on CT scan:
- ACCs are large, heterogeneous enhancing masses of soft tissue attenuation.
- Internal hemorrhage is seen as ill-defined areas of increased attenuation on non-contrast-enhanced CT and as areas of high signal intensity on T1-weighted images
- Areas of necrosis have low attenuation on non–contrast-enhanced CT, high signal intensity on T2-weighted images and do not enhance after administration of iv contrast (105).
- Calcifications, which are best detected on CT imaging as high attenuation foci, can be present in approximately30%of cases. These are either coarse calcifications or microcalcifications and usually centrally located. Calcification is also present in other adrenal pathologies such as myelolipoma and 10% of pheochromocytomas and hence is not a distinguishing feature (106).
- Some ACCs may contain areas of intracellular lipid and rarely macroscopic fat resulting in CT density measurements of 10 HU in portions of the tumor (107).
- Contrast-enhanced imaging often demonstrates heterogeneous, predominantly irregular peripheral enhancement with central nonenhancing areas secondary to hemorrhage or necrosis. Contrast-enhanced CT scan is a reliable method of disease staging, identifying common metastatic sites such as regional and para-aortic lymph nodes, lungs, liver, and bones (98).
- CT imaging of the chest, liver, and bone scan are used for staging workup to detect metastasis.
