What are the symptoms of adrenal cancer?
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Symptoms of Adrenal Cancer
Adrenal cancer, also known as adrenocortical carcinoma (ACC), is a rare but aggressive malignancy of the adrenal glands. The symptoms of adrenal cancer can vary widely depending on the hormonal activity of the tumor and the extent of its growth. Below, we explore the common symptoms associated with adrenal cancer, supported by recent research findings.
Hormonal Symptoms: Hypercortisolism and Cushing’s Syndrome
One of the hallmark symptoms of adrenal cancer is the overproduction of hormones, particularly cortisol. This condition, known as hypercortisolism, often leads to Cushing’s Syndrome. Patients with Cushing’s Syndrome may experience a range of symptoms including weight gain, muscle weakness, and high blood pressure . Chronic high levels of glucocorticoids can also stimulate aldosterone receptors, causing hypertension and hypokalemia (low potassium levels).
Physical Symptoms: Abdominal and Flank Pain
As the tumor grows, it can cause physical discomfort. Common symptoms include abdominal pain, flank pain, and a feeling of fullness or early satiety due to the mass effect of the tumor. These symptoms are often indicative of significant tumor growth, typically when the tumor reaches a size of 10-13 cm.
Non-Specific Symptoms: Fatigue and General Weakness
Fatigue and general weakness are frequently reported by patients with adrenal cancer. These symptoms can be easily overlooked as they are common in many other conditions, including other types of cancer and chemotherapy side effects. General weakness was the most common symptom observed in a study of cancer patients with adrenal insufficiency.
Rare and Atypical Presentations
In some cases, adrenal cancer can present with atypical symptoms. For instance, one study reported a patient with pale skin and non-specific abdominal pain, which led to a diagnosis of adrenal carcinoma. Another case highlighted recurrent hypokalemia as an unusual presentation for metastatic adrenocortical cancer.
Gender-Specific Symptoms
Research indicates that adrenal tumors are more common in females, and women may report more symptoms compared to men. Symptoms such as hirsutism (excessive hair growth) and virilization (development of male characteristics) in females, and gynecomastia (breast enlargement) and hypogonadism (reduced function of the gonads) in males, are associated with hormonal imbalances caused by the tumor .
Conclusion
Adrenal cancer presents with a variety of symptoms, primarily driven by hormone excess and tumor growth. Common symptoms include signs of hypercortisolism, abdominal pain, and general weakness. However, atypical presentations can occur, making diagnosis challenging. Awareness of these symptoms can aid in early detection and improve patient outcomes.
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Most relevant research papers on this topic
Rare Case of Huge Adrenocortical Carcinoma in Surprisingly Asymptomatic Patient
Pale skin: An adrenal cancer?
Preclinical Cushing's syndrome in adrenal "incidentalomas": comparison with adrenal Cushing's syndrome.
Adrenal tumours are more predominant in females regardless of their histological subtype: a review
The Gynecologic Aspects of Adrenal Tumors
The pain, depression, and fatigue symptom cluster in advanced breast cancer: covariation with the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system.
Clinical Features and Risk Factors of Adrenal Insufficiency in Patients With Cancer Admitted to the Hospitalist-Managed Medical Unit
Altered Hypothalamus-Pituitary-Adrenal Axis Function: A Potential Underlying Biological Pathway for Multiple Concurrent Symptoms in Patients With Advanced Lung Cancer
Pediatric adrenal cortical carcinomas: Histopathological criteria and clinical trials. A systematic review.
Recurrent Hypokalemia as an Unusual Presentation for Metastatic Adrenocortical Cancer
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