The endocrine system performs the most important functions in our body, it is responsible for the hormonal secretion and includes many organs like the adrenal glands, thyroid gland, pancreas, etc. When the tumors in these organs arise, organic activity is disrupted.
In medical practice, adrenal tumors with hormonal activity are not uncommon. Such formations include corticosteroids - the most complex endocrinological benign or malignant tumor processes.
The concept of a corticosterone
Corticosteroma is a hormonally active adrenal tumor that produces corticosteroid hormones.
In children, corticosteroids are usually malignant in nature. Glucosteromas are tumor formations originating from the adrenal medulla.
These tumors produce corticosteroid hormones, in particular cortisol. To an insignificant degree, there may be an excess of hormones such as androgens or aldosterone.
Glucosteroma is usually accompanied by symptoms of Itenko-Cushing syndrome or hypercorticism of the endogenous type.
In endocrinological practice, both malignant and benign variants of tumor corticosteroid processes are found. Moreover, the smaller the parameters of education and the older the patient's age, the more likely that the tumor has a benign nature.
Benign glucosteromas weighing not more than 200 g, and their diameter is not more than 15 cm. Such tumors are placed in a tight connective tissue capsule with an abundant and well-developed blood network( vascularization).
Malignant corticosteroids can grow to 0.8-1.2 kg. They differ in their tuberous surface and consist of a lot of dead regions and zones of hemorrhage.
Malignant tumors are usually represented by corticoblasts and adenocarcinomas, they are distinguished by hematogenous and lymphogenous metastasis. Metastatic foci also produce hormones, even after removal of the affected adrenal and primary tumor.
Causes of pathology
Etiology of the tumor has not been sufficiently studied.
Endocrinologists among the most likely provoking factors are called:
- Aggressive external environment;
- Hereditary predisposition;
- Medicinal effect of medicines.
Usually hormonal activity of glucosteroma is the excessive synthesis of glucocorticoids, which leads to atrophic changes in the adrenal glands.
Hypercorticism manifests catabolic effects on muscle, bone and connective tissue structures, which leads to systemic dystrophic changes.
And since glucocorticoids have an immunosuppressive effect, the patient has a tendency to infectious pathologies.
Symptoms of
Patients with corticosteroid usually complain of such problems:
- General organic weakness;
- Excessive fatigue;
- Skin changes. The skin becomes dry, there is excessive keratinization, red spots appear on the surface of the body. Even at low pressure, subcutaneous hemorrhage occurs. In the areas of excess fatty deposits appear cyanotic and purple-red striae. Against the backdrop of pathologically low immune status, the slightest skin lesions result in suppuration, trophic ulceration, etc.;
- Obesity;
- Rapid fatigue;
- Changes in appearance due to unusual distribution of adipose tissue on the body - there are many faces on the body and torso, and there are no extra pounds on the legs;
- Frequent headaches;
- Presence of bone and muscle pain;
- A marked decrease in sexual desire;
- Permanent thirst caused by disturbances in water-electrolyte metabolism;
- Because of the use of a large amount of fluid in patients there are abundant and frequent urination, in which there is a sharp decrease in the specific gravity of urine;
- Virilization in women. It appears as an increase in the clitoris, increased hairiness of the body and face, brittle hair on the head, dysmenorrhea, or amenorrhea;
- In men, there are signs of feminization - the potency decreases, the penis diminishes, there are hypoplastic processes in the testicles, breast enlargement, etc.;
- On the background of hypercorticism, osteoporosis is formed in patients, leading to frequent fractures;
- A characteristic feature of corticosteroma is persistent hypertension, myocardial insufficiency, heart palpitations, etc.
- Approximately 30% of patients have urolithiasis or chronic pyelonephritis;
- Encephalopathy, astheno-depressive syndrome. It is characterized by the presence of sleep and memory disorders, accompanied by mood swings, depressive states and psychoses.
Diagnosis of a tumor
A specialist is faced with a serious task in determining the true causes of such a condition.
The leading diagnostic value is given to procedures for determining the level of corticosteroid hormones. Patients are given a Liddl test with dexamethasone.
Additional diagnostics are carried out, including visualization studies like:
- Ultrasound;
- Magnetic Resonance Imaging;
- Multislice computed tomography with contrast;
- Scintigraphy.
The patient needs additional neurological, gynecological, urological, cardiac consultation.
Treatment of adrenal corticosteroid
If there is an adrenal corticosteroma, there can be only one treatment method - surgery. And the earlier the operation is performed, the greater the probability of a favorable outcome of the pathology.
The affected adrenal gland is removed by open or endoscopic method together with corticosteroma.
Forecast of the disease
If the corticosteroid is benign, the operation and postoperative therapy is performed correctly, then the predictions for cure and life are favorable.
Over time, the patient's appearance is restored, pressure and metabolism are normalized, weight is reduced, bones are strengthened, the psyche and sexual functions are also restored.
The patient is recommended continuous monitoring of the endocrinologist. For malignant corticostero, the predictions are unfavorable.