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Endocrine Surgery

Adrenal Tumors

Adrenal cortical cancer (ACC)

  • What are risk factors for adrenal cancer?
    • The majority of ACCs are sporadic and without risk factors.
    • There are two rare genetic syndromes that are associated with ACC: Li-Fraumeni and Beckwith-Wiedemann Syndromes.

  • How is it diagnosed?
    • Definitive diagnosis is only made on final pathology. However, certain characteristics of the tumor on imaging studies  make it highly suspicious for ACC.

  • What is the treatment?
    • If surgically resectable: open adrenalectomy and en-bloc removal of the tumor, the surrounding tissues, any invading structures and the regional lymph nodes.
    • Adjuvant therapy with mitotane and possibly chemotherapy is usually recommended.
    • Unresectable tumors: mitotane, chemotherapy, and clinical trials with newer biologic agents.

  • Is adrenal cancer serious? What is the prognosis?
    • Adult adrenal cortical cancer is an aggressive tumor that is not usually found until it has advanced to a later stage and therefore has a poor prognosis.
    • Prognosis for smaller tumors that are confined to the adrenal gland and removed early can have a five year survival of up to 65%.
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  • Can my cancer come back?
    • Since ACC is an aggressive tumor, it can definitely come back either locally (in the same location) or in a distant location as metastatic disease.

  • Are there risk factors for recurrence?
    • Completeness of surgical resection, size, stage at diagnosis, and tumor biology are the most important factors for recurrence.

  • How is my cancer monitored after surgery?
    • You will have lifelong follow-up with an oncologist, surgeon, and endocrinologist.
    • Monitoring will consist of periodic imaging and blood tests to monitor for recurrence and/or disease progression.
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University of Southern California
Upper G.I. and General Surgery

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