Adrenal Cancer

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Signs and Symptoms

Adrenal cancer does not always produce symptoms. Both nonfunctioning adrenocortical carcinomas and large functioning tumors may cause the following:

• Fever
  
• Palpable (able to be felt with the fingers) abdominal mass
  
• Persistent abdominal pain
  
• Sensation of abdominal "fullness"
  
• Weight loss
  

Additional symptoms of functioning adrenocortical carcinoma depend on which hormones are overproduced. Overproduction of androgens (e.g., dehydroepiandrosterone, estrogen) usually does not produce symptoms in men because the testicles produce testosterone, which is a more potent androgen. Rarely, abnormal breast enlargement (gynecomastia) occurs in men. Excess androgens may cause early puberty in children and masculinization (i.e., abnormal facial and body hair, deepening voice) in women and children.

Complications

A functioning adrenocortical tumor that produces excess cortisol may result in Cushing's syndrome. Approximately 30–40% of patients with Cushing's syndrome and an adrenal mass are diagnosed with adrenal cancer.

Symptoms of Cushing's syndrome include the following:

• Absence of menstruation (amenorrhea)
  
• Bruising easily
  
• Excessive growth of facial and body hair in women (hirsutism)
  
• Flushing (reddish complexion)
  
• High blood pressure (hypertension)
  
• Increased blood sugar, diabetes (hyperglycemia)
  
• Increased body fat (adiposity) in the face, neck, and abdomen
  
• Loss of bone mass (osteoporosis); may cause spinal curvature
  
• Severe acne
  
• Slowed growth rate in children
  
• Stretch marks (abdominal striae)
  
• Weakness and muscle wasting
  

Conn's syndrome is caused by increased aldosterone production and may result from a functioning tumor in the adrenal cortex. Symptoms of Conn's syndrome include the following:

• Chronic excessive thirst (polydipsia)
  
• Excessive urination (polyuria)
  
• High blood pressure (hypertension)
  
• Low level of potassium in the blood (hypokalemia)
  

The hallmark of pheochromocytoma is sudden or sustained high blood pressure that is often resistant to treatment. Other symptoms include severe headaches, sweating, heart palpitations (rapid pulse), and nausea.

Symptoms of neuroblastoma include abdominal pain and bone pain resulting from metastatic disease.

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