Cited by 423Adrenal and Paraganglionic TumorsRenal cell carcinoma treatmentAdrenal Hormones and Disorders

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Adrenocortical Carcinoma: Diagnosis, Evaluation and Treatment

NG, LINDA, LIBERTINO, JOHN M.·2003·Journal of Urology

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Abstract

PURPOSE: We describe the presenting features, imaging methods, prognosis of and treatment approach to adrenocortical carcinoma. MATERIALS AND METHODS: A comprehensive literature review of adrenal carcinoma was performed using PubMed and a review of current urology, oncology, radiology and pathology journals. RESULTS: The incidence of adrenocortical tumors has been reported to be approximately 2/1 x 10(6) population, although this value may be an underestimate due to an increase in the incidence of unexpected adrenal masses or incidentalomas in the last decade. There has been a bimodal age incidence of adrenal carcinoma with most patients 40 to 50 years old in the studies reviewed. Overall the prevalence of adrenal tumors was slightly higher in females with most presenting with Cushing's syndrome. Of the 602 adrenal tumors reviewed 62% were functional and 38% were nonfunctional. Modern day imaging, including ultrasound, computerized tomography (CT) and magnetic resonance imaging, have greatly improved the diagnosis and staging of adrenal carcinoma. Surgical removal of a localized tumor and absent metastatic disease were associated with improved survival. Medical therapy with mitotane and its successors in patients with metastatic disease appear to be of little benefit for improving survival. CONCLUSIONS: Based on a review of the literature we recommend that hormone levels should be determined in symptomatic and asymptomatic patients with adrenal masses. CT should be the first study done to define an adrenal mass. All solid incidentalomas greater than 5 cm. on CT or magnetic resonance imaging should be removed surgically. The best chance of survival was achieved by surgical extirpation with the value of adjuvant therapy yet to be determined.

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Authors: NG, L., & LIBERTINO, J. M.
Affiliations: Lahey Hospital and Medical Center (US)
Venue: Journal of Urology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-01
Volume: 169
Issue: 1
Pages: 5-11
ISSN: 0022-5347 (ISSN-L)
1527-3792
DOI: 10.1016/s0022-5347(05)64023-2
OpenAlex: W2105268776
Cited by: 423
References: 37
Citations by year: 2026: 8 · 2025: 10 · 2024: 22 · 2023: 15 · 2022: 17 · 2021: 22 · 2020: 21 · 2019: 22 · 2018: 13 · 2017: 14 · 2016: 24 · 2015: 28 · 2014: 24 · 2013: 13 · 2012: 25
FWCI: 3.82
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Journal of Urology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
Health Sciences › Medicine › Oncology › Renal cell carcinoma treatment
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords: adrenocortical carcinoma, adrenal tumors, Cushing's syndrome, adrenal incidentaloma, functional adrenal tumors, adrenal imaging, computed tomography, magnetic resonance imaging, mitotane, adjuvant therapy, surgical resection, prognosis
MeSH terms: Adrenal Cortex Neoplasms, Humans, Prognosis, Adrenocortical Carcinoma

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