Adrenocortical Cancer. Results of Examination of Patients at the Clinic of High Medical Technologies
Vol. 70 No. 1 (2024), ORIGINAL ARTICLES. C. CLINICAL RESEARCH
Vol. 70 No. 1 (2024)

Adrenocortical Cancer. Results of Examination of Patients at the Clinic of High Medical Technologies

ORIGINAL ARTICLES. C. CLINICAL RESEARCH
https://doi.org/10.37469/0507-3758-2024-70-1-88-95
Published 07.03.2024
Dina Vladimirovna Rebrova
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0002-7840-4174
Ilya Valeryevich Sleptsov
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0002-1903-5081
Roman Anatolyevich Chernikov
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0002-3001-664X
Igor Konstantinovich Chinchuk
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0001-6986-1034
Vladimir Fyodorovich Rusakov
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0002-6807-778X
Leonid Mikhailovich Krasnov
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0003-4449-0251
Elisey Aleksandrovich Fedorov
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0002-1294-811X
Arseny Andreevich Semenov
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0001-6760-0025
Tatyana Viacheslavovna Savelyeva
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0002-2846-4056
Olga Ivanovna Loginova
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0002-2484-4895
Shamil Shamsudinovich Shikhmagomedov
Saint Petersburg State University, Saint Petersburg State University Hospital
https://orcid.org/0000-0002-3876-6306
Natalya Vladimirovna Vorokhobina
North-Western State Medical University n.a. I.I. Mechnikova
https://orcid.org/0000-0002-9574-105X
Valentina Viktorovna Kalugina
North-Western State Medical University n.a. I.I. Mechnikova
https://orcid.org/0000-0002-2812-6911
Sergei Nikolaevich Fogt
North-Western State Medical University named after I.I. Metchnikov
https://orcid.org/0000-0001-8734-2449
pdf (Русский)

Keywords

adrenocortical cancer
differential diagnosis
cushing syndrome

How to Cite

Rebrova, D. V., Sleptsov, I. V., Chernikov, R. A., Chinchuk, I. K., Rusakov, V. F., Krasnov, L. M., Fedorov, E. A., Semenov, A. A., Savelyeva, T. V., Loginova, O. I., Shikhmagomedov, S. S., Vorokhobina, N. V., Kalugina, V. V., & Fogt, S. N. (2024). Adrenocortical Cancer. Results of Examination of Patients at the Clinic of High Medical Technologies. Voprosy Onkologii, 70(1), 88–95. https://doi.org/10.37469/0507-3758-2024-70-1-88-95
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Abstract

Materials and Methods. The article describes the results of the examination of 76 patients with adrenocortical cancer (ACC), who have undergone surgery in the in-patient facility of the N.I. Pirogov Clinic of High Medical Technologies of St. Petersburg State University. ACC was diagnosed from 2009 to 2020. Patient demographic data, baseline disease characteristics, tumor hormonal activity, and computed tomography (CT) data were described.

Results. Overall, the data obtained were consistent with the international literature with respect to age at onset of the disease (median age 45 years), the ratio of females to males (3:1), and the incidence of hypercortisolism (48.8 %). It was found that the combination of radiographic density ≤ 20 HU and mass size less than 4 cm does not exclude all cases of ACC. According to the findings 2 (3.3 %) of 65 patients would not be diagnosed if the above criteria had been used. Within the CT data analysis, about one-third of patients showed no increase in the standard thresholds for absolute and relative percentage washout (RPW) that defines malignancy. The results analysis revealed that the subgroup of patients with Cushing syndrome had a statistically significant increase in contrast washout rates.

Conclusion. Overall, the findings in ACC patients in the studied population are consistent with the literature data. The study results suggest that the diagnostic value of contrast washout parameters for differential diagnosis of ACC is limited, especially in patients with small tumors and with Cushing syndrome. According to the data obtained, the most reliable criterion for excluding ACR is native tumor radiodensity < 10 HU; the use of this criterion made it possible to exclude all cases of ACC.

https://doi.org/10.37469/0507-3758-2024-70-1-88-95
pdf (Русский)

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