Adrenal tumor pathophysiology: Difference between revisions

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==Tumors of the Adrenal Cortex==
The [[adrenal cortex]] is composed of three distinct layers of [[endocrine]] cells which produce critical [[steroid hormone]]s. These include the [[glucocorticoid]]s which are critical for regulation of [[blood sugar]] and the [[immune system]], as well as response to physiological [[stress]], the [[mineralcorticoid]] [[aldosterone]], which regulates [[blood pressure]] and [[kidney]]function, and certain [[sex hormone]]s. Both [[benign]] and [[cancer|malignant]] tumors of the adrenal cortex may produce steroid hormones, with important clinical consequences.
 
===Adrenocortical adenoma===
''Adrenocortical adenomas'', or adrenocortical "nodules", are small, benign tumors of the adrenal cortex which are extremely common (present in 1-10% of persons at autopsy). The clinical significance of these neoplasms is twofold. First, they have been detected as[[incidental finding]]s with increasing frequency in recent years, due to the increasing use of [[CT scan]]s and [[magnetic resonance imaging]] in a variety of medical settings. This can result in expensive additional testing and invasive procedures to rule out the slight possibility of an early [[adrenocortical carcinoma]]. Second, a minority of adrenocortical adenomas are "functional", meaning that they produce [[glucocorticoid]]s, [[mineralcorticoid]]s, and/or [[sex hormone|sex steroids]], resulting in endocrine disorders such as [[Cushing's syndrome]], [[Conn's syndrome]] (hyperaldosteronism), [[virilization]] of females, or[[feminization (biology)|feminization]] of males. Functional adrenocortical adenomas are surgically curable.
 
===Adrenocortical carcinoma===
:''Main article: [[Adrenocortical carcinoma]]
Adrenocortical carcinoma (ACC) is a rare, highly aggressive [[cancer]] of adrenal cortical cells, which may occur in children or adults. ACC's may be "functional", producing [[steroid hormone]]s and consequent [[endocrine]] dysfunction similar to that seen in many adrenocortical adenomas, but many are not. Due to their location deep in the [[retroperitoneum]], most adrenocortical carcinomas are not diagnosed until they have grown quite large. They frequently invade large vessels, such as the [[renal vein]] and[[inferior vena cava]], as well as [[metastasis|metastasizing]] via the [[lymphatics]] and through the [[blood]] to the [[lung]]s and other organs. The most effective treatment is [[surgery]], although this is not feasible for many patients, and the overall[[prognosis]] of the disease is poor. [[Chemotherapy]], [[radiation therapy]], and [[hormonal therapy (oncology)|hormonal therapy]]may also be employed in the treatment of this disease.


==References==
==References==
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[[Category:Surgery]]
 
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Latest revision as of 02:33, 24 October 2017