“Although the majority of these tumors are benign, around 30% of adrenal tumors (>4cm) are malignant (most represented by ACCs), and the survival rate for these patients is very poor unless detected early.”
When the tumor is found at the early stage and can be removed surgically, the five-year survival rate is 50-60 percent. The prognosis for adrenal cancers that have spread to nearby or distant organs is much less favorable, with only 10-20 percent surviving five years. Risk Factors.
Most adrenal gland tumors are benign, or noncancerous, but need to be treated if symptoms appear. There are several types of adrenal tumors that may require treatment.
A primary adrenal gland tumor is very uncommon. Each year, an estimated 600 people in the United States are diagnosed with adrenocortical carcinoma. This type of cancer is much less common than an adrenal adenoma, which is a noncancerous tumor that is found most commonly in middle-aged and older adults.
Most tumors in the adrenal glands are not cancer. (These may be called benign tumors.) It's often hard to tell if an adrenal tumor is cancer (malignant) or benign. If the tumor grows and spreads to lymph nodes or other parts of the body, it's cancer.
The vast majority of all adrenal tumors in people without any known cancer are adenomas, which are benign. They grow more slowly than malignant tumors. Research suggests the growth rate is between 0.3 and 2.8 mm a year, whereas malignant adrenal tumors may grow between 5.8 and 395.4 mm a year.
Our data suggest that growth less than 3 mm/year is relatively common in adrenal adenomas and, therefore, should still be considered consis- tent with benignity if the patient does not have risk factors, such as known primary malignancy elsewhere.
Adrenal cancer, also called adrenocortical cancer, can occur at any age. But it's most likely to affect children younger than 5 and adults in their 40s and 50s.
Advanced adrenal cancer: Stage 3 and stage 4 adrenal cancer means the tumor has spread to other parts of your body. Usually, cancer cells spread first to nearby lymph nodes. Advanced cancer can also spread to other organs, tissues, blood vessels and bones.
[5] Adrenocortical carcinomas are very aggressive lesions and in some cases may be functional and present with Cushing syndrome and/or virilization. In most cases, ACC is non-functional and presents as an abdominal mass or an incidental finding.
The size of the mass is the most important predictor of the risk of malignancy. All adrenal lesions more than 4 cm in size should be removed. [32,33] There is much controversy in surgical removal of smaller lesions (<4 cm). However, many institutions recommend surgery for masses 3-4 cm in size.
NYU Langone doctors often perform surgery to remove adrenal tumors that are causing symptoms, also called functional tumors. Removing these tumors helps you avoid long-term health problems, such as high blood pressure, stroke, heart attack, weight gain, diabetes, and kidney problems.
Certain types of adrenal tumors can be removed safely without removing the entire adrenal gland. This approach may be recommended for patients with tumors on both adrenal glands, like pheochromocytomas.
Most benign adrenal tumors cause no symptoms and don't need treatment. But sometimes these tumors secrete high levels of certain hormones that can cause complications. The most common hormones that can be over-secreted are aldosterone and cortisol from the cortex and adrenalin hormones from the medulla.
Adenoma. This is the most common type of adrenal gland tumor. Adenoma is also called an adrenocortical adenoma. It is a noncancerous tumor of the adrenal cortex that can be functioning or nonfunctioning.
Your treatment may include a combination of surgery, radiation therapy, and chemotherapy. Palliative care will also be important to help relieve symptoms and side effects. For many people, a diagnosis of metastatic cancer is very stressful and difficult.
Symptoms of adrenal cancer might include weight gain, muscle weakness, trouble sleeping, deepening voice and increased hair growth, usually on the face (in women), pain in the abdomen or lower back, weight loss or loss of appetite.
Cancer stage grouping
Stage I: The tumor is 5 cm or smaller and has not grown beyond the adrenal gland. It has not spread to the regional lymph nodes or to other parts of the body (T1, N0, M0).
In fact, to date, only eight case reports and one small case series of six patients in the literature have reported on patients with ACC who have achieved long-term survival of more than 10 years [10,14–21].
The most common symptom reported by patients with adrenocortical cancer is pain in the back or side (called the flank). Unfortunately, this type of pain is common and does not directly suggest a disease of the adrenal cortex.
Many people don't realize they have an adrenal adenoma until their healthcare provider discovers an adrenal gland tumor during an imaging procedure for an unrelated medical condition. These tumors are sometimes called “incidentalomas” because they're found incidentally, or by chance.
The most common organ to which adrenal cortical cancer spreads (distant metastases) are the liver and lung.
In autopsy series, adrenal masses larger than 0.5 cm in size are rather common (occurring in approximately 2% to 9% of people), and adrenal masses larger than 1 cm in size are found in 1.3% to 3.4% of patients who undergo abdominal or chest CT scans [3].