Adrenocortical carcinoma CT
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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]
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
- Ct=T scan of the chest are routinely performed to look formetastases to the lungs 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.