Adrenal Gland Carcinomas

General characteristics

Adrenal gland carcinomas are counted among the rare malignant diseases and can be hereditary. From 50 to 75% of adrenal gland carcinomas are hormone-producing tumors.

Clinical symptoms

Due to the relatively small hormone production, characteristic symptoms such as Cushing’s syndrome occur in delayed phases of the disease. In up to 90% of cases, adrenal gland carcinomas therefore measure more than 6 cm at the time of diagnosis.

Imaging

In one third of patients, metastases to the lung, the liver and the locoregional lymph nodes have occurred by the time of diagnosis.

Direct spread into the kidney, the inferior vena cava, and the retroperitoneum are often seen. Therefore, in patients with suspected adrenal gland carcinoma examination of the liver and the entire retroperitoneum is strongly recommended. Adrenal gland carcinomas are hyperintense compared to the liver on T2-weighted images. Large tumors often demonstrate inhomogeneous SI values on T2-weightedeigted images due to necrosis and calcifications. They are ill defined.

Contrast enhancement

The SI after bolus injection of a paramagnetic contrast agent can compare to that of metastases. On contrast-enhanced T1-weighted images, there is much better demarcation of necrotic areas within the tumor. Infiltration of the inferior vena cava is not uncommon.