Androgen- and Estrogen-Secreting Adrenal Cancers

The document from 2010 reviews the characteristics, diagnosis, and treatment of rare androgen- and estrogen-secreting adrenal cancers. It notes that these cancers are a small fraction of cases presenting with androgen excess in women and that estrogen-secreting adrenal cancers are even rarer. The presence of metastases is the most reliable indicator of malignancy. Surgery is the primary treatment, with mitotane being evaluated for its potential role. The prognosis for adrenocortical carcinomas (ACCs) is poor, with a 5-year survival rate of around 30%. The document also discusses the clinical presentation, the importance of distinguishing these cancers from benign conditions, and the use of biochemical tests and imaging for diagnosis. A small study of 17 cases of ACC showed that estrogen receptor positivity was correlated with a better prognosis. The document suggests an algorithm for investigating female patients with hyperandrogenism and highlights the potential of IGF-2 and GLUT-1 over-expression as future diagnostic and prognostic tools. Novel treatments based on molecular targeting are hoped to improve outcomes for these cancers.