Evaluation, Staging, and Surgical Management for Adrenocortical Carcinoma: An Update from the SSO Endocrine and Head and Neck Disease Site Working Group

Annals of Surgical Oncology
Paxton V DicksonCarmen C Solórzano

Abstract

This is the first of a two-part review on adrenocortical carcinoma (ACC), a rare and aggressive malignancy that often presents at an advanced stage. Most patients present with symptoms related to cortisol and/or androgen excess. Appropriate biochemical evaluation and imaging is important in assessing the extent of disease, operative planning, and oncologic surveillance for patients with ACC. For patients with locoregional disease, potential cure requires margin-negative resection, and accumulating evidence suggests that regional lymphadenectomy should be performed. Although laparoscopic adrenalectomy is reported by some to be adequate for localized ACC, open resection in the hands of an experienced adrenal surgeon is the gold standard for operative management of this disease. Cure is rare following disease relapse, however select patients with severe symptoms related to hormone excess or pain may benefit from resection of local or distant recurrence. For best oncologic outcomes, it is recommended that all patients with ACC be treated at centers with multidisciplinary expertise in management of this rare and aggressive malignancy.

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Citations

Sep 19, 2018·Annals of Surgical Oncology·Barbra S Miller
Jul 14, 2020·Annals of Surgical Oncology·Olivia M DelozierPaxton V Dickson
Oct 10, 2020·World Journal of Surgery·Alaa SadaElizabeth B Habermann
Apr 10, 2021·Cancer Genetics·Madeline B TorresJaydira Del Rivero
Aug 28, 2021·Biomedicines·Giuseppe CavallaroClaudio Letizia
Sep 24, 2019·Surgery·Alaa SadaTravis J McKenzie
Nov 19, 2021·Annals of Surgical Oncology·Joshua TsengMonica Jain

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Adrenocortical Carcinoma

Adrenocortical carcinoma (ACC) is a rare malignancy of the adrenal cortex, associated with a generally dismal prognosis owing to its aggressive behavior. Here are the latest discoveries pertaining to this disease.