Adrenal cancer, also known as adrenocortical carcinoma (ACC), is a rare but aggressive cancer that forms in the outer layer of the adrenal glands. These glands sit above the kidneys and are responsible for producing essential hormones such as cortisol, aldosterone, and androgens. Because the adrenal glands regulate metabolism, blood pressure, immune response, and reproductive functions, adrenal cancer can cause widespread effects on the body.
ACC can be functioning (producing excess hormones) or non-functioning (not producing hormones). Functioning tumors cause noticeable symptoms due to hormone overproduction, while non-functioning tumors may grow silently until they become large or spread.
Symptoms depend on the type of hormones produced. Excess cortisol can cause Cushing’s syndrome, characterized by rapid weight gain, round face, muscle weakness, high blood pressure, diabetes, and mood changes. Excess androgens may cause deepening of the voice, acne, and irregular periods in women, or early puberty in children. Excess aldosterone can lead to high blood pressure, muscle cramps, and low potassium levels. Large tumors may cause abdominal pain, fullness, or a visible lump.
Risk factors for adrenal cancer include certain genetic disorders such as Li-Fraumeni syndrome, Beckwith–Wiedemann syndrome, and congenital adrenal hyperplasia. However, most cases occur without a known cause. Because symptoms resemble common hormonal disorders, adrenal cancer is often diagnosed at an advanced stage.
Diagnosis includes blood and urine hormone tests, CT or MRI scans, PET scans, and sometimes biopsy. Imaging helps determine tumor size and spread. Early detection greatly improves treatment outcomes.
Surgical removal of the adrenal gland (adrenalectomy) is the primary treatment for localized cancer. Complete removal with clear margins offers the best chance for cure. For advanced or metastatic disease, additional treatments such as chemotherapy, mitotane (a specialized adrenal cancer drug), radiation therapy, and targeted therapies may be used. Mitotane helps reduce hormone production and slow tumor growth.
Because adrenal cancer is rare and complex, long-term follow-up is necessary. Patients require monitoring of hormone levels, imaging studies, and management of side effects caused by hormone imbalance. Early diagnosis and treatment improve survival, and ongoing research is exploring better treatment options.
