What is Adrenocortical Carcinoma (ACC)?

ACC is a rare and aggressive cancer originating in the adrenal cortex (the outer layer of the adrenal gland). Only about 1-2 in a million people are diagnosed per year.

Symptoms:

• Hormone Overproduction: About 60% of ACCs make excess cortisol, aldosterone, or sex hormones, causing Cushing's syndrome, virilization (excess male hormones in women), or feminization (in men).
• Mass Effect: Abdominal pain, feeling of fullness, or a palpable lump.
• No Symptoms: Some are found as large incidentalomas.

Diagnosis:

• CT or MRI: Large (usually >6 cm), irregular mass with invasion into nearby structures.
• Biopsy: Usually NOT done before surgery (risk of spreading cancer).
• Metastases: ACC often spreads to liver, lungs, and bones.

Treatment:

• Surgery: Complete removal (if possible) is the only chance for cure.
• Mitotane: A chemotherapy drug specific for adrenal cancer. It is toxic but can shrink tumors.
• Radiation/Other Chemo: Used for metastatic disease.

Prognosis:

ACC is aggressive. 5-year survival is about 35-50% for localized disease, but much lower if it has spread.