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Adrenocortical carcinoma

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Adrenocortical carcinoma

Adrenocortical carcinoma (ACC) is an aggressive cancer originating in the cortex (steroid hormone-producing tissue) of the adrenal gland. Adrenocortical carcinoma is remarkable for the many hormonal syndromes that can occur in patients with steroid hormone-producing ("functional") tumors, including Cushing's syndrome, Conn syndrome, virilization, and feminization. Adrenocortical carcinoma has often invaded nearby tissues or metastasized to distant organs at the time of diagnosis, and the overall 5-year survival rate is about 50%. Adrenocortical carcinoma is a rare tumor, with incidence of one to two per million population annually. It has a bimodal distribution by age, with cases clustering in children under 5 and in adults 30–40 years old. The widely used angiotensin-II-responsive steroid-producing cell line H295R was originally isolated from a tumor diagnosed as adrenocortical carcinoma. Adrenocortical carcinoma can occur at any age, with the highest incidence between 40 and 60 years of age. Women are more frequently affected (55 to 60%) than men (40 to 45%). Adrenocortical carcinomas usually occur sporadically in adults. However, they sometimes occur as part of hereditary syndromes, such as:

Li-Fraumeni syndrome Lynch syndrome Multiple endocrine neoplasia (MEN) Familial adenomatous polyposis (see also adenomatosis)

Infobox

Other names
Adrenal cortical carcinoma, adrenocorticocarcinoma, adrenal cortical cancer, adrenal cortex cancer
Specialty
Oncology

Tables

· Diagnosis › Differential diagnosis
High nuclear grade (enlarged, oval to lobated, with coarsely granular to hyperchromatic chromatin and easily discernible, prominent nucleoli)
High nuclear grade (enlarged, oval to lobated, with coarsely granular to hyperchromatic chromatin and easily discernible, prominent nucleoli)
Characteristic
High nuclear grade (enlarged, oval to lobated, with coarsely granular to hyperchromatic chromatin and easily discernible, prominent nucleoli)
Score
1
More mitoses than 5/50 high power fields
More mitoses than 5/50 high power fields
Characteristic
More mitoses than 5/50 high power fields
Score
1
Atypical mitoses
Atypical mitoses
Characteristic
Atypical mitoses
Score
1
Eosinophilic cytoplasm in >75% of tumor cells
Eosinophilic cytoplasm in >75% of tumor cells
Characteristic
Eosinophilic cytoplasm in >75% of tumor cells
Score
1
Diffuse architecture of >33% of tumor
Diffuse architecture of >33% of tumor
Characteristic
Diffuse architecture of >33% of tumor
Score
1
Necrosis
Necrosis
Characteristic
Necrosis
Score
1
Venous invasion
Venous invasion
Characteristic
Venous invasion
Score
1
Sinusoidal invasion (no smooth muscle in wall)
Sinusoidal invasion (no smooth muscle in wall)
Characteristic
Sinusoidal invasion (no smooth muscle in wall)
Score
1
Capsular invasion
Capsular invasion
Characteristic
Capsular invasion
Score
1
Characteristic
Score
High nuclear grade (enlarged, oval to lobated, with coarsely granular to hyperchromatic chromatin and easily discernible, prominent nucleoli)
1
More mitoses than 5/50 high power fields
1
Atypical mitoses
1
Eosinophilic cytoplasm in >75% of tumor cells
1
Diffuse architecture of >33% of tumor
1
Necrosis
1
Venous invasion
1
Sinusoidal invasion (no smooth muscle in wall)
1
Capsular invasion
1

References

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