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)