Above, above each kidney are located paired glandular organs - the adrenal glands, which deal with the production of hormones that support vascular health and protect against stresses that control the distribution of BIO and water-salt balance.
Adrenal malignant tumors are rarely detected in medical practice. Most often this organ affects benign tumor processes.
Description
Adrenal cancer is a malignant lesion of glandular tissue and occurs in about 3-5% of the total number of malignant oncologies. The greatest danger of such a cancer is for the pulmonary and hepatic structures, in which it most often metastasizes.
According to the ICD, the adrenal cancer is assigned code D35.0.
Causes of pathology
In general, malignant adrenal lesions may have a hereditary or sporadic etiology.
Specialists note that it can trigger factors such as:
- The use of carcinogens, which are found in large quantities in some beverages and foods;
- Unhealthy habits such as eating tobacco or alcohol;
- Age features. Cancer of this nature affects mainly young children and older patients;
- Predispositions of a family nature, the presence of a genetic predisposition to cancerous adrenal processes;
- Multiple endocrine tumors;
- The presence of hereditary pathologies such as Li-Fraumeni syndrome, hyperplastic polyposis, Beckwit-Wiedemann, etc.
It is rather difficult to determine the causes of adrenal cancer definitively, therefore the etiology of the disease is often unknown.
Classification of
All subcortical tumors are divided into two categories:
- Cortical layer formation;
- Tumors of the medulla.
In addition, adrenal cancer can be primary and secondary. Primary tumors can be hormonally active or inactive. In addition, adrenal tumors are divided into:
- Corticosteroids - such formations disrupt the flow of material exchange processes;
- Androsteromas - form the emergence in women of secondary sexual characteristics;
- Aldosteromes - disrupt the water-salt balance in the body;
- Corticoandrosteromas - such tumors combine androsteromas and corticosteroids;
- Pheochromocytomas - are formed in the adrenal medulla
- Neuroblastoma - are formed mainly in children;
- Carcinomas are the most common type of adrenal cancer.
Photo of a mixed hormone-associated cancer of the adrenal gland of the adrenal gland
Adrenal cancer is staged as follows:
- I stage is typical for a tumor no greater than 5 cm;
- II stage - the tumor is more than 5 cm, but there is no invasion;
- Stage III of the is a different-sized tumor that has a local invasion but does not grow into neighboring organs;
- IV stage - different-sized tumors that have an invasion of neighboring organs.
Adrenocortical adrenal cancer
If a malignant tumor originates and the adrenal cortical layer, then it is called adrenocortical cancer. Other names of this type of oncology are corticoblastoma, adrenal cortical cancer or adrenal cancer.
A similar tumor is more common in women after 40 and children under 5 years. In the latter, the tumor is formed from residual embryonic adrenal cellular structures. In women, this pathology is often caused by a prolonged and uncontrolled intake of oral contraceptives.
Symptoms of tumors
Clinical features of adrenal tumors are very diverse and are caused by a specific type of tumor.
Any abnormalities in the body that have a hormonal etiology may also occur in this case. This includes children's osteoporosis, obesity, weakness of muscle tissue, hypertensive crises or hypertension.
If the formation produces male hormones, then women develop signs of masculinization, such as voice changes, severe musculature, hair loss and coarse facial features. Adrenal cancer causes active production of hormonal substances.
With pheochromocytoma, active metastasis and cardiovascular complications are observed.
With corticoestroma, there are signs of malaise, weakness of muscle tissue, probably the development of paralysis of the legs or hands, may be worried about increased blood pressure and convulsions. With cancer of the adrenal cortex, excessive production of corticosteroid hormones is observed.
Specific symptoms are complemented by symptoms such as:
- Digestive disorders, nausea-vomiting syndrome and dyspepsia;
- Rapid weight loss and lack of appetite;
- Reduced stress resistance, frequent neuroses, apathy and depressive conditions;
- Syndrome of anemia, stretch marks on the skin;
- Pain symptomatology localized or diffuse nature, which depends on the metastatic orientation;
- Deficiency in the body of potassium;
- Excessive anxiety and frequent attacks of panic attacks;
- Total body exhaustion;
- Disorders of libido;
- Atypical acne.
For pheochromocytoma, hyperpotency, rapid heart rate, high blood pressure, dyspnea, paleness of the skin and headaches are most typical.
Neuroblastoma adrenal tumors mostly manifest with bone pain, bulging eyes, having dark circles around them, children may swell up their belly, breathing becomes difficult, the patient quickly loses weight and suffers from severe diarrhea.
In malignant lesions of the adrenal cortex, patients show signs of obesity, chubby and round cheeks, feminization in men or masculinization in women, the appearance of a fatty hump just below the neck, etc.
Metastases Most often metastatic adrenal cancer occurs in the organs and tissues of the abdominal cavity, bone tissue, stomach, pulmonary and hepatic structures.
If the cancer is secondary, it can be a consequence of metastasis of adrenal tumors like melanoma or pulmonary cancer.
Diagnosis of
Oncological patients with suspected adrenal cancer are shown to conduct a thorough diagnosis, which includes:
- Chest X-ray, which allows the detection of metastasis in lung tissue or other organic structures;
- Positron emission tomography, which allows to determine the scale of the tumor process, specify the stage of development of education and assess the possibility of performing surgical removal;
- Magnetic resonance imaging - especially recommended such a diagnosis in case of suspected metastasis in the structures of the brain or spinal cord, etc.;
- Ultrasound diagnosis, which helps to identify the tumor and the presence of hepatic metastases;
- Computed tomography - visualizes the formation, shows the presence of lesions in lymph nodes and other organic structures, helps to decide on the method of surgical intervention and the scope of the operation;
- Laboratory studies of biomaterials such as urine and blood, allowing to determine the hormone level, to clarify the location of the primary focus, etc.
General methods of treatment of adrenal cancer
The main method of treatment of adrenal tumors, especially hormoneally active, is surgery.
- At the first stage of tumor development, when the formation does not exceed 5 cm and there is no metastasis, laparoscopic removal is performed.
- If the education has reached the second stage of development and has grown more than 5 cm, then the method of removal is determined by doctors based on MRI or CT.
- At stage 3 of adrenal cancer, when the tumor affects the lymph nodes, a cavitary operation is indicated. During removal, the surgeon examines nearby organs and tissues for the presence of metastases.
- Adrenal cancer of the 4th stage is usually accompanied by metastatic sprouting in the tissues of the kidneys, liver, etc. Such tumors are not always operable. The possibility of prompt removal is determined by the doctor individually.
Other methods are used as an additional treatment. Radiotherapy is actively used in pheochromocytomas.
The chemotherapeutic effect is of low effectiveness, therefore it is used only in case of extensive metastasis.
Sometimes, in order to reduce the hormonal productivity of the adrenal cortex, medicinal therapy with drugs such as Chloditane, Mitotana, etc. is additionally prescribed. The course duration is about 2 months. The drugs have side reactions like nausea and vomiting, lack of appetite, frequent headaches and a sense of intoxication.
After treatment, the patient is shown constant medical supervision and periodic follow-up examinations. Such an approach will allow a timely relapse.
Survival prognosis
The level of postoperative survival depends directly on the extent of the oncological process.
In treatment of stage 1-2 of adrenal cancer, approximately 80% of the cases achieve positive results of therapy. But at 4 stages of cancer, the predictions are negative, because there is extensive metastasis.
In general, the survival rate of cancer patients with stage 1 cancer is about 80%, with the second - 50%, with the third - 20%, with the fourth - 10%.
Very unfavorable prognosis of survival has an adrenal carcinoma, such cancer survivors live less than a year and a half. Even with the early detection and treatment of a tumor, the lifespan of such patients is very low.
Video shows the removal of the adrenal tumor: