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Annals of Surgical Oncology

, Volume 25, Issue 12, pp 3460–3468 | Cite as

Evaluation, Staging, and Surgical Management for Adrenocortical Carcinoma: An Update from the SSO Endocrine and Head and Neck Disease Site Working Group

  • Paxton V. Dickson
  • Lawrence Kim
  • Tina W. F. Yen
  • Anthony Yang
  • Elizabeth G. Grubbs
  • Dhavel Patel
  • Carmen C. Solórzano
Endocrine Tumors

Abstract

This is the first of a two-part review on adrenocortical carcinoma (ACC), a rare and aggressive malignancy that often presents at an advanced stage. Most patients present with symptoms related to cortisol and/or androgen excess. Appropriate biochemical evaluation and imaging is important in assessing the extent of disease, operative planning, and oncologic surveillance for patients with ACC. For patients with locoregional disease, potential cure requires margin-negative resection, and accumulating evidence suggests that regional lymphadenectomy should be performed. Although laparoscopic adrenalectomy is reported by some to be adequate for localized ACC, open resection in the hands of an experienced adrenal surgeon is the gold standard for operative management of this disease. Cure is rare following disease relapse, however select patients with severe symptoms related to hormone excess or pain may benefit from resection of local or distant recurrence. For best oncologic outcomes, it is recommended that all patients with ACC be treated at centers with multidisciplinary expertise in management of this rare and aggressive malignancy.

Notes

Disclosure

None of the authors has any financial disclosures related to this work.

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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Paxton V. Dickson
    • 1
  • Lawrence Kim
    • 2
  • Tina W. F. Yen
    • 3
  • Anthony Yang
    • 4
  • Elizabeth G. Grubbs
    • 5
  • Dhavel Patel
    • 6
  • Carmen C. Solórzano
    • 7
  1. 1.Department of Surgery, Division of Surgical OncologyUniversity of Tennessee Health Science CenterMemphisUSA
  2. 2.Division of Surgical Oncology and Endocrine SurgeryUniversity of North CarolinaChapel HillUSA
  3. 3.Division of Surgical OncologyMedical College of WisconsinMilwaukeeUSA
  4. 4.Department of Surgery, Division of Surgical OncologyNorthwestern University Feinberg School of MedicineChicagoUSA
  5. 5.Department of Surgical OncologyUniversity of Texas MD Anderson Cancer CenterHoustonUSA
  6. 6.Endocrine Oncology BranchNational Institutes of HealthBethesdaUSA
  7. 7.Division of Surgical Oncology and Endocrine SurgeryVanderbilt UniversityNashvilleUSA

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