Interesting case of the week: Adrenal Cancer – No symptoms
The patient is a 69-year-old woman with an incidentally noted right adrenal tumor.
She had a CT scan back in September 2020 to evaluate a kidney cyst on the left side. The scan picked up on a nodularity on the right adrenal gland measuring 2.1 cm.
Fortunately, her doctors did not ignore her adrenal tumor. She was also sent to a medical endocrinologist who did a complete hormone work up. They made sure she did not have aldosterone-, cortisol-, or adrenaline- overproduction.
One year later they repeated the CT scan. Now the tumor had grown to 2.5 cm. On the CT scan there the tumor had an “atypical imaging phenotype”. This means that the tumor has some concerning features. The tumor was lipid-poor. This means that it does not have a lot of fat in it. This is a concerning sign.
At this point the patient was referred to me. When I reviewed all her scans, I was sufficiently concerned about this tumor that I recommended surgery. I recommended surgery even though the patient did not have any symptoms.
I review all the scans myself in great detail. I have looked at thousands of adrenal tumors on CT, PET and MRI scans. Her scan was concerning to me.
The patient underwent an uncomplicated right mini back scope adrenalectomy (MBSA). The operation lasted 21 minutes.
Two days later our specialist adrenal pathologist called me. Indeed, the suspicion I had about the scans was verified. The patient had an adrenocortical cancer (also known simple as adrenal cancer, or ACC).
Fortunately, because it was detected early it was still Stage 1. Importantly, all the margins were negative. This means the cancer was completely removed. It is likely that the patient will have a surgical cure and do very well.
We have already set up a team of doctors who will keep a very close eye on her for many years to come.
#adrenal #adrenalsurgery #carlingadrenalcenter #adrenalsurgeon #adrenaltumor #adrenalgland #adrenalcancer #adrenocorticalcancer #adrenalglands #tampabay
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