Surgery for adrenocortical carcinoma: When and how?

摘要: Adrenocortical carcinoma (ACC) is a rare malignancy that frequently asymptomatic at presentation, yet has high rate of metastatic disease the time diagnosis. Prognosis overall poor, particularly with cortisol-producing tumors. While treatment ACC guided by stage disease, complete surgical resection most important step in management patients primary, recurrent, or ACC. Triphasic chest, abdomen, and pelvis computer tomography (CT) scans 18F flourodeoxyglucose positron emission CT scanning are essential for accurate staging; moreover, MRI may be helpful to identify liver metastasis evaluate involvement adjacent organs operative planning. Surgical negative margins single prognostic factor survival To achieve highest R0 resection, open adrenalectomy gold standard approach confirmed highly suspected It extremely tumor capsule not ruptured, regardless used. The best post-operative outcomes (complications oncologic) achieved high-volume surgeons practicing centers.