Adrenocortical adenoma is commonly described as a benign neoplasm emerging from the cells that comprise the adrenal cortex. Like most adenomas, the adrenocortical adenoma is considered a benign tumor since the majority of them are non-functioning and asymptomatic. Adrenocortical adenomas are classified as ACTH-independent disorders, and are commonly associated with conditions linked to hyperadrenalism such as Cushings syndrome (hypercortisolism) or Conns syndrome (hyperaldosteronism), which is also known as primary aldosteronism. In addition, recent case reports further support the affiliation of adrenocortical adenomas with hyperandrogenism or florid hyperandrogenism which can cause hyperandrogenic hirsutism in females. "Cushings syndrome" differs from the "Cushings disease" even though both conditions are induced by hypercortisolism. The term "Cushings disease" refers specifically to "secondary hypercortisolism" classified as "ACTH-dependent Cushings syndrome" caused by pituitary adenomas. In contrast, "Cushings syndrome" refers specifically to "primary hypercortisolism" classified as "ACTH-independent Cushings syndrome" caused by adrenal adenomas. Presentation
Adrenal adenomas are often categorized as endocrine-inactive tumors considering that majority of them are non-functioning and asymptomatic. Functional adrenocortical adenomas demonstrate symptoms consistent with mixed endocrine syndromes. In most reported cases of adrenocortical adenoma, patients have presented with one or multiple endocrine syndromes such as hyperaldosteronism/Conns Syndrome, hypercortisolism/Cushings syndrome, hyperandrogenism/feminization, virilization, or hirsutism. Some of the common symptoms associated with adrenocortical adenomas include:
Musculoskeletal

Osteopenia
Muscle weakness/muscle atrophyCardiovascular

HypertensionEndocrine and Metabolic

Obesity→More prevalent in males

virilization→More prevalent in females

Hyperandrogenism
Irregular menstrual cyclesNeuropsychological

Sleep disorders
DepressionSkin

Easy bruising
Stretch marks
Hirsutism
Acne

Cause
Study of the reported cases indicate that most adrenocortical adenomas occur due to neoplastic proliferation of adrenal cortical cells within the three distinct layers of adrenal cortex.
Surgical excision may be required if its presence is resulting in atrophy of the adrenal glands and the surrounding tissues.In order to acquire better treatment strategies, it is important to further examine, study and discern the distinct molecular mechanisms involved in the formation of endogenous Adrenal Adenomas, hyperplasias, and ACTH-independent Cushings Syndrome to improve the available diagnostic and prognostic markers that can assist clinicians in the management and advance-treatment of such conditions. Prognosis
The long-term outlook for individuals diagnosed with non-functional adrenocortical adenoma is usually excellent. The long-term outlook for individuals diagnosed with functional adrenocortical adenoma is good with early diagnosis and treatment. Epidemiology
Prevalence: Female > Male
More common in adults
Relatively earlier onset in females (ages ≤ 20) than males (ages ≤ 30)
Most common cause of ACTH-independent Cushings syndrome

See also
Hyperplasia
Adrenal tumor
Cushings syndrome
Conns syndrome
Hypercortisolism
Hyperaldosteronism
Hyperandrogenism
Adrenal gland
Adrenal paraganglioma
Adrenal Pheochromocytoma
Adrenal ganglioneuroma

References


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