Adrenocortical Tumors: Clinical and Diagnostic Findings

Abstract

From the clinical point of view (Table 1), hormone-secreting adrenocortical tumors are of particular interest because autonomous excessive secretion of steroid hormones causes characteristic clinical syndromes. Thus, excessive production of aldosterone leads to the syndrome of hypermineralocorticoidism and excessive cortisol secretion to Cushing’s syndrome, whereas the inappropriate secretion of androgens and estrogens by adrenocortical tumors may cause virilization of female patients (Gabrilove et al. 1981), feminization of male patients (Gabrilove et al. 1965), and precocious puberty in children. If present, inappropriate hormone secretion dominates the clinical picture, leads to elaborate differential diagnostic procedures, and gives an unequivocal indication for the localization and removal of adrenocortical tumors, while the question of malignancy often seems to be of secondary interest. However, approximately half of hormone-producing adrenocortical tumors are malignant, with a great tendency for metastatic spread and often showing a poor response to radiotherapy and chemotherapy.