Adrenal cortical carcinoma. A series of 22 cases.

Objectives: Analysis of the treatment of a series of patients with adrenal cortical carcinoma. Material and Methods. This series consists of 22 patients (15 women and 7 m en) with a mean age of 35 years (range: 23 to 58 years). 55% of patients ha n a non-secreting armour; 45% of tumours were associated with excessive hor monal secretion. The tumour was located on the right side in 12 cases and o n the left side in 11 cases (the tumour was bilateral in 1 case). Ultrasoun d and CT were sufficient for localization of the tumour: The patients were classified as stage 1: 3 cases, stage II: 2 cases, stage III.: 8 cases, sta ge IV: 9 cases, according to MacFarlane's classification. Results: Adrenalectomy was performed in 18 patients. Two patients died duri ng the operation and another 8 died within the first four. years. Eight pat ients are currently alive, including 7 with ao signs of recurrence; one pat ient presented a large local recurrence 39 months after adrenalectomy. Conclusion: Surgery remains the only effective treatment at the present rim e. The diagnosis of adrenal cortical carcinoma must be made as early as pos sible.