Diagnosis And Management Of Adrenocortical Carcinoma (21 Cases Report)

Objective :To study the clinical presentation and management of adrenocortical carcinomas and improve the diagnosis and management level of adrenocortical carcinomas .Methods : Retrospectively analyzed the clinical presentation ,imaging character, surgical management , radiotherapy , chemotherapy and prognosis of 21 cases of adrenocortical carcinomas.Among them 15 cases are primary adrenocortical carcinomas and 6 cases are metastatic adrenocortical carcinomas .In primary ACC (adrenocortical carcinoma) ,6 cases are functional tumors:5 cases show Cushing's syndrome ,1 case is female child and present virilizing syndrome ,there is no case of primary aldosteronism in this group ,and 9 ACC s are nonfunctional tumors.All of the 15 cases of primary ACC underwent B-US examination,11 cases were diagnosed as ACC ,4 cases were misdiagnosed as adenomas, accuracy rate of diagnosis by B-US was 73%(11/15).In primary ACCs, 11 cases underwent CT examination , 9 cases were diagnosed as ACCs ,2 cases were misdiagnosed as adenomas, accuracy rate of diagnosis by CT was 82%(9/11).4 cases underwent MRI examination , tumor embolus was found in the left renal vein in 1 case.The maximal diameter of the tumors ranged 3~20cm ,with an average diameter of 8cm .there were 2 cases of Sullivan stageâ… ,3 cases of stageâ…¡,4 cases of stageâ…¢,6 cases of stageâ…£.Result :In 15 cases of primary ACC ,13 cases underwent surgical management . 7 cases underwent complete resection ,complete tumor resection along with kidney were conduct in 2 cases . 4 cases underwent imcomplete resection .3 cases died within 1 year:1 month, 2 months and 6 months after operation .2 cases without operation died in 3 months and 8 months after diagnosis . 2 cases died within 1~5 years :17 months and 18 months after operation ,1 case lost follow up after 2 years'survival . 2...