Adrenocortical carcinoma (ACC)

What is adrenocortical carcinoma?

• Malignant tumor emerging from the adrenal cortex
• It affects approximately 1-2 people per million each year
• It can be hormonally active (e.g. excess cortisol, androgen hormones) as well as inactive

How does it manifest itself?

• Cushing's syndrome — increased cortisol: weight gain, weakness, high pressure, diabetes
• Virilization in women — excess androgen hormones: hair growth, acne, menstrual changes
• Local symptoms — pain in the side or back
• However, the tumor can be asymptomatic for a long time and manifest itself only at an advanced stage

Diagnostic procedure

• Hormonal profile — tests e.g. on cortisol, DHEA-S, androstenedione, testosterone, 17-OH progesterone
• Imaging methods — CT/MRI to assess size, local infiltration and metastasis
• Functional imaging methods — PET/CT (e.g. 18F-FDG) to evaluate tumor activity and extent
• Biopsies are not normally performed — there is a risk of spreading the tumour

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