By David E. Schteingart (auth.), Gary D. Hammer, Tobias Else (eds.)
This first version of the textbook “Adrenocortical Carcinoma: easy Sciences and medical techniques” presents a concise compilation of correct facts advancing our present knowing of this infrequent melanoma. Chapters are devoted to numerous elements of either the elemental biology and the medical technological know-how when it comes to adrenocortical carcinoma (ACC). professional clinicians introduce the reader to present cutting-edge scientific care of sufferers with ACC. As a substantial physique of data on ACC has collected over the past many years, professional scientists have authored extra sections that function a reference resource for the skilled researcher in addition to an creation for the trainee within the laboratory or hospital. medical themes span the epidemiology, prognosis and treatment of ACC. clinical issues parts span the pathology and pathophysiology of ACC with a different concentrate on experimental versions of adrenocortical tumors and up to date advances within the genetic elements and signaling pathways in ACC. The content material of this e-book was once compiled and edited with the cause of facilitating the interpretation of data into destiny diagnostic and healing instruments that would eventually enhance sufferer care.
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Additional info for Adrenocortical Carcinoma: Basic Science and Clinical Concepts
3 are case sketches provided courtesy of the author N. W. Thompson) 1. Adequate steroid preparation and maintenance in patients with Cushing’s syndrome or while on long-term mitotane therapy. 2. In case of a high suspicion of an ACC, needle biopsy is contraindicated pre-operatively; spillage of tumor cells will prevent cure (Fig. 1a, b). 3. Incisions allowing wide local exposure of the tumor and intra-abdominal metastases, making every effort to avoid rupturing the tumor capsule when it is localized and potentially curable.
In a recent analysis of the cytologic features of 20 adrenocortical carcinomas (9 primary tumors and 11 metastases) from 19 patients, a varied morphologic spectrum was found with the potential of diagnostic confusion . As no single specific feature allows a definitive diagnosis of ACC, a combination of cytologic features is required. The typical cytologic features included hypercellularity, necrotic debris, nuclear pleomorphism, mitotic figures, and prominent nucleoli . However, the authors have pointed out that pathological findings need to be combined with clinical information to achieve a proper FNA diagnosis.
However, no specific pattern of associated tumors could be detected, and up to now no specific germline mutations have been identified in these patients. References 1. Bovio S et al (2006) Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest 29(4):298–302 2. Grumbach MM et al (2003) Management of the clinically inapparent adrenal mass (incidentaloma). Ann Intern Med 138(5):424–429 3. Kloos RT et al (1995) Incidentally discovered adrenal masses.