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The adrenal gland is located on top of
each kidney. It is divided into two sections: the adrenal medulla and the adrenal cortex.
Each has a different function, but in general the overall function of the gland is to make
steroid hormones.
Although there are two parts
to the adrenal gland, the vast majority of malignancies of the adrenal gland occur in the
cortex. Carcinomas of the adrenal gland are considered either functional or
nonfunctional; that is, they either produce steroids (which may lead to clinical symptoms)
or they don't. This disease is very rare, affecting 2 per 1 million people.
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- Staging this disease
- Staging allows the physician to gauge the amount of and the
location of tumor in the body by using information gathered from imaging studies such as
CT scans, MRIs, etc., as well as information from pathology and physical examination. Once
a stage has been defined, the physician can make a prediction of how the patient may do
over time, and determine what sort of therapy might be necesssary.
There is no formally adopted staging system for adrenal
carcinoma at this time. However, the one most often used places patients into one of four
categories. Variables taken into account include: tumor size; presence or absence of
invasion into the kidney or other nearby organs; the presence or absence of lymph node
involvement; and the presence or absence of distant disease (such as lung, liver or bone
involvement). Stages may be generally divided into the following:
| Stage 1:
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Small tumors (less than 2 inches) without
evidence of local invasion; absence of nodal involvement and absence of distant disease.
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| Stage 2:
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Tumors larger than 2 inches without evidence of
local invasion; absence of nodal involvement and absence of distant disease.
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| Stage 3:
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Tumors of any size that exhibit nodal
involvement. |
| Stage 4:
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A mixed group consisting of tumors that invade
adjacent structures; any tumor that has evidence of distant spread; or any tumor that has
invaded the kidney and has positive nodal involvement.
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- Prognosis
- Prognosis is determined by the interaction of disease stage
and aggressiveness as defined by number of cells dividing when examined under the
microscope.
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