Adrenal Cancer Flashcards
Adrenal Cancer
The triangular right
gland relates to the diaphragm posteriorly and the inferior vena cava and liver
anteriorly.
The semilunar left adrenal gland is positioned in the middle of the left
crux of the diaphragm.
--- I is true II is true I & II are true neither are true
I & II both true
The paired suprarenal (adrenal) glands are located between the superomedial
aspects of the kidney and the diaphragmatic crura. They are surrounded by
connective tissue containing perinephric fat. The glands are enclosed by renal
fascia but separated from the kidneys by fibrous tissue. The triangular right
gland relates to the diaphragm posteriorly and the inferior vena cava and liver
anteriorly. The semilunar left adrenal gland is positioned in the middle of the left
crux of the diaphragm. The omental bursa separates it from the stomach. It is
also related to the spleen and pancreas
Adrenal Cancer
Which arterial blood supply originates from the renal artery?
inferior suprarenal artery
***The superior suprarenal arteries are derived from the inferior phrenic
artery, the middle suprarenal arteries from the abdominal aorta near the origin of
the superior mesenteric artery, and the inferior suprarenal arteries from the renal
artery. A large central vein leaves the anterior surface of the gland at the hilum.
The shorter right suprarenal vein drains into the inferior vena cava, and the
longer left suprarenal vein drains into the left renal vein.
Adrenal Cancer
The inferior lymphatic trunks end in aortocaval lymph
nodes located near the origin of the celiac plexus.
The superior lymphatic trunks
end in lateroaortic nodes above the renal pedicle.
TRUE or FALSE?
False. Other way around
***
The lymphatic drainage follows the arterial supply and is predominantly to
lumbar lymph nodes. The superior lymphatic trunks end in aortocaval lymph
nodes located near the origin of the celiac plexus. The inferior lymphatic trunks
end in lateroaortic nodes above the renal pedicle. Some trunks may pass through
the diaphragm, following the splanchnic nerves, ending in retroaortic nodes in
the posterior mediastinum. On the right, some lymphatic trunks may penetrate
the liver.
Adrenal Cancer
A. ACC (adrenocortical carcinoma) is more common in women
B. Nonfunctional carcinomas are more common in older population (>30)
C. Functional carcinomas are more common in men
D. Functional tumors are more common in younger patients
All of the above are TRUE except?
C.
women: acc and functional
men: nonfunctional
older: non functional
younger: functional
Overall, adrenocortical carcinoma (ACC) is slightly more common in women than in men.
Nonfunctional carcinomas occur in an older age population (>30 years old) and are more common in men (3:2 male-to-female ratio), although functional tumors are more common in women (7:3 female-to-male ratio) and younger patients.
Adrenal cancer
Which of the following syndromes is the least likely associated with ACC?
Li Fraumeni MEN-1 MEN-2 Beckwith-Wiedeman SBLA
MEN-2
***
Although most cases of ACC are sporadic, it has been described as a component of several hereditary cancer syndromes, including Li-Fraumeni syndrome (breast cancer, soft tissue and bone sarcoma, brain tumors, and ACC), Beckwith-Wiedemann syndrome (Wilms tumor, neuroblastoma, hepatoblastoma, and ACC), multiple endocrine neoplasia type I (MEN-I) (parathyroid, pituitary and pancreatic neuroendocrine tumors, and adrenal adenomas and carcinomas), and SBLA syndrome (sarcoma, breast, lung, ACC, and other tumors).
Adrenal Cancer
Which of the following syndromes is the least likely associated with pheochromocytoma?
MEN-IIA MEN-IIB vHL Beckwith Wiedemann NF von Recklinghausen disease
Beckwith Wiedemann
***
Bilateral pheochromocytomas are a component of multiple endocrine neoplasia type IIa (MEN-IIA) syndrome (pheochromocytoma, medullary thyroid carcinoma, and parathyroid hyperplasia) or MEN-IIB syndrome in which they are associated with marfanoid habitus, mucosal neuromas, and medullary thyroid carcinoma.
Pheochromocytomas occur in 25% of patients with von Hippel-Lindau syndrome and <1% of patients with neurofibromatosis and von Recklinghausen disease.
Adrenal Cancer
Extra-adrenal tumors are more commonly benign.
Incidentally discovered masses <3 cm are rarely malignant.
only I is true
only II is true
both are true
both are false
only II is true
***
I is false
Extra-adrenal tumors are more commonly malignant.
Adrenal Cancer
Which of the following syndromes is the most likely associated with bilateral pheochromocytoma?
MEN-IIA
vHL
NF
von Recklinghausen disease
MEN-IIA
Adrenal Cancer
Which side is more commonl;y affected? left or right?
1:1
Adrenal Cancer
Which is typically a larger mass? nonfunctioning or functioning?
nonfunctioning.
because functioning produces hormones, they are diagnosed at an early stage.
Adrenal Cancer
All of the following are true, EXCEPT:
I. ACC is an aggressive malignancy that frequently violates the tumor
capsule and invades surrounding tissues.
II. It metastasizes to lungs, liver, brain and regional lymph nodes.
III. Many patients present with widespread metastasis;
most of these patients die within 6 months of diagnosis.
IV. Widespread disease is
especially common in the elderly population.
IV.
pediatric
Adrenal Cancer
TNM staging
What is the T-stage?
Tumor invading adjacent organs
T4
Adrenal Cancer
TNM staging
What is the T-stage?
Tumor outside adrenal in fat?
T3
Adrenal Cancer
TNM staging
What is the T-stage?
No invasion ≤5 cm
T1
Adrenal Cancer
TNM staging
What is the T-stage?
No invasion >5 cm
T2
Adrenal Cancer
TNM staging
N1
+LN
Adrenal Cancer
TNM staging
What is the stage grouping?
T4,N0,M0
IV
Adrenal Cancer
TNM staging
What is the stage grouping?
T3,N1,M0
IV
Adrenal Cancer
TNM staging
What is the stage grouping?
M1
IV
Adrenal Cancer
TNM staging
What is the stage grouping?
T3,N0,M0
III
Adrenal Cancer
TNM staging
What is the stage grouping?
T2,N0,M0
II
Adrenal Cancer
TNM staging
What is the stage grouping?
T1,N1,M0
III
