Surgical management of adrenocortical carcinoma

Endocrinol Metab Clin North Am. 2015 Jun;44(2):435-52. doi: 10.1016/j.ecl.2015.02.008. Epub 2015 Mar 17.

Abstract

Adrenocortical carcinoma (ACC) is rare but one of the most malignant endocrine tumors. This article reviews and summarizes the current knowledge about the treatment of ACC. The epidemiology and molecular events involved in the pathogenesis of ACC are briefly outlined. The different diagnostic tools to distinguish benign from malignant adrenocortical tumors, including biochemical analysis and imaging, are discussed. The surgical treatment of ACC has evolved in the last 2 decades. The different surgical alternatives for the treatment of ACC in the context of primary, recurrent, or metastatic disease are reviewed, and the remaining challenges and controversies are discussed.

Keywords: Adrenocortical carcinoma; Adrenocortical tumor; Chemotherapy for adrenocortical carcinoma; Metastatic adrenocortical carcinoma; Mitotane treatment; Open adrenalectomy.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Neoplasms / drug therapy
  • Adrenal Cortex Neoplasms / pathology
  • Adrenal Cortex Neoplasms / surgery*
  • Adrenalectomy*
  • Adrenocortical Carcinoma / drug therapy
  • Adrenocortical Carcinoma / pathology
  • Adrenocortical Carcinoma / surgery*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Bone Neoplasms / secondary
  • Bone Neoplasms / surgery
  • Chemotherapy, Adjuvant
  • Humans
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Lung Neoplasms / secondary
  • Lung Neoplasms / surgery
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Mitotane / therapeutic use
  • Neoplasm Recurrence, Local / surgery*

Substances

  • Antineoplastic Agents, Hormonal
  • Mitotane