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How to identify adrenal cancer through imaging examination? The magical decoding of CT and MRI images!
Adrenocortical carcinoma (ACC) is an aggressive cancer originating from the adrenal cortex, which is mainly responsible for the production of steroid hormones.Adrenal cancer is characterized by the possibility of a variety of hormone syndromes in patients, including Cousin syndrome, Cori syndrome, masculinization and feminization.At the time of diagnosis, adrenal cancer has usually invaded surrounding tissues or metastasized to distant organs, with an overall five-year survival rate of about 50%.ACC is a rare tumor with about one to two cases per million population per year.The disease is bimodal in age, mainly concentrated in children under five years of age and adults aged 30 to 40.
How adrenal cancer performs in imaging examinations will be discussed in depth in the following paragraphs.
Symptoms and symptoms of adrenal cancer
Symptoms of adrenal cancer may differ significantly in children and adults.For children, most tumors are functional, and virilization is the most common symptoms, followed by Kuxing syndrome and premature puberty.Hormone syndrome in adults is mainly Kuxing syndrome, which is in combination with masculinization (over-secretion of glucocorticoids and androgens).Feminization and Cori Syndrome (excessive mineral corticosteroids) account for only less than 10% of the cases in this disease.
Pathophysiology
The main cause of adrenal cancer is not yet known, however, according to the family history of Li-Fraumeni syndrome, the syndrome is caused by a hereditary inactivation mutation in TP53, which increases the risk of onset.Some genes such as TP53, CTNNB1, MEN1, etc. have been confirmed to have cyclic mutations.Tumor manifestations are closely related to chromosomes and genes, especially in fetal growth.
Diagnosis Methods
Laboratory Examination
Hormone syndrome must be confirmed through laboratory examinations.Laboratory tests of Kuxing syndrome showed elevated blood sugar and increased urinary cortisol.Adrenal masculinization was confirmed by excessive serum androthenone and dehydroepiandone.Coriolis syndrome has characteristics such as hypokalemia and high aldosterone concentration.
Imaging test
Imaging of the abdomen, such as CT scans and magnetic resonance imaging (MRI), is of great significance to identify the location of the tumor, distinguish other diseases (such as benign adrenal tumors), and determine the extent of invasion of the tumor to surrounding organs and tissues.On CT, the tumor showed a non-uniform appearance and may be accompanied by necrosis, calcification, and bleeding.After the injection of the contrast agent, an enhanced signal appeared at the tumor edge.
Whether in CT or MRI, it is crucial for imaging diagnosis of adrenal cancer.
Treatment Plan
The only cure for adrenal cancer is complete resection of the tumor.The surgery can still be performed even if the tumor has invaded large blood vessels, such as the renal vein or inferior vena cava.However, many patients are not candidates for surgery, and the five-year survival rate after surgery remains around 50% to 60%.
Prognosis
The overall prognosis of adrenal cancer is relatively poor, with a five-year survival rate of about 50%.Five-year disease-free survival rate is approximately 30% after complete resection of stage I to III adrenal cancer.The main factors affecting prognosis include patient age and tumor stage, and pathological characteristics such as schizoelectric activity, venous invasion and tumor size also have significant effects.
Imaging plays an indispensable role in the diagnosis and treatment of adrenal cancer.For future research on adrenal cancer, we should think about: How to further improve imaging technology to enhance the early diagnosis rate of adrenal cancer?
