Adrenal Cancer

According to the benign or malignant nature, adrenal cancer can be classified as benign tumors and malignant tumors. Based on the presence or absence of endocrine function (such as the production of some hormones causing hypertension), it can be classified into non-functional tumors and functional tumors; According to the site of occurrence, it can be divided into cortical tumor, medullary tumor, stromal tumor, or metastatic tumor. The adrenal tumors that are usually surgically treated in clinical practice are mostly functional tumors or suspected malignant (or tumors that cannot be benign or malignant before surgery).

Introduction to Adrenal and Adrenal Cancer

The adrenal gland is an important endocrine organ in the body. Because of its close relationship with the kidney, it has long been considered a urological disease. The human adrenal gland is located on the left and right sides behind the peritoneum. Its lower outer side is in close contact with the upper inner side of the two kidneys. Adrenal gland at a glance has the shape and size of a slightly bent adult last finger. Its head, body and tail also look like the shape of the last finger from the root to the tip.

Physiological Function of the Adrenal Gland

The public's attention and expectations have been strong, and a lot of research and work have been made in this area. In the field of biochemical and pharmacological research, great progress has been made. It has been known that in addition to adrenaline, norepinephrine and dopamine can also be extracted from the adrenal medulla. They have fewer side effects than adrenaline and often have better hemodynamic effects for increasing blood pressure and saving lives. More importantly, with regard to the function of the adrenal cortex, we have known through nearly half a century of research that there are more than 40 kinds of corticosteroids (chemically named steroids or steroids) that can be produced and secreted from the adrenal cortex. Taking into account some available intermediate products or derivatives, there are more than 70 kinds of these substances. Corticosteroids can be roughly divided into three categories, which are briefly introduced as follows:

• Regulating glucose and protein metabolism

The glucocorticoids are represented by cortisol. It is widely used inclinical practice as cortisone. This kind of hormone can promote the deamination of amino acids into ketones to promote gluconeogenesis and maintain the concentration of blood glucose. The lack of this hormone can easily cause hypoglycemia. When this hormone is in excess, gluconeogenesis is enhanced, which can damage proteins or inhibit their synthesis, leading to subcutaneous fat increase, increased blood sugar, thin skin with purple lines, muscle weakness, and osteoporosis. In addition, glucocorticoids also have an effect on the metabolism of many substances. Combined with insulin, auxin, adrenal medulla hormone, etc., to regulate the metabolism of substances and energy supply in the human body and coordinate and balance each other's physiological activity.

• Regulating salt and water metabolism

Hormones that regulate salt and water metabolism - Mineralocorticoids are represented by aldosterone. It is applied clinicallyby deoxycorticosterone acetate. This hormone makes the renal tubules reabsorb sodium and chlorine and secrete potassium and phosphorus. In the absence of this hormone, the plasma sodium concentration is reduced, water is lost, blood is concentrated, and blood potassium is increased. When there is an excess of this hormone, the situation is the opposite, that is, the sodium content in the blood is increased and the potassium content is decreased. Corticosteroids can also have some effect on the metabolism of sugar and protein, but the effect is relatively light. The production and secretion of mineralocorticoids are mainly regulated by the renin-angiotensin system under physiological conditions. Followed by the effects of blood potassium and adrenocorticotropic hormone.

• Regulating weak male hormone secretion

The adrenal cortex also secretes weak male hormone such as dihydroepiandrosterone, androstenedione and a very small amount of testosterone, which do not play an important role in adult marriage and childbearing. But for male and female adolescents, it can promote their earliest secondary sexual characteristics such as armpit hair and pubic hair to appear, as well as the maturation of the hypothalamic pituitary gonadal axis, thereby promoting their healthy development during puberty. The adrenacortex also secretes a small amount of estrogen, which generally has no practical significance. However, in patients with adrenal tumors, the content is increased. This can lead to male patients having impotence and infertility, female patients can cause menstrual disorders.

Conclusion

Adrenal cancer is a rare and invasive malignant tumor that has varied clinical features according to hormone production. Early disease can be diagnosed on imaging and hormonal assays, and the only opportunity for cure of local disease is resection. Chemotherapy (mainly mitoxan-based regimens) and new targeted therapies are the mainstay of therapy for late or recurrent disease, and may help prolong survival. Multidisciplinary nursing and close follow-up are also important to control recurrences and treat side effects of these treatments. Ongoing research into the genetic basis of cancer and new therapeutic strategies also continue to add to the treatment armamentarium and raise the hope of better outcomes in the future.