Σταδιοποίηση Ca Επινεφριδίων

 

Ca Επινεφριδίων

AJCC Stages

Stages

T

N

M

I

T1

N0

M0

II

T2

N0

M0

III

T1

N1

M0

T2

N1

M0

T3

N0

M0

IV

T3

N1

M0

T4

N0

M0

T4

N1

M0

Any T

Any N

M1

(T) Primary Tumor

TX

Primary tumor cannot be assessed

T0

No evidence of primary tumor

T1

Tumor ≤ 5 cm in greatest dimension, no extraadrenal invasion

T2

Tumor > 5 cm, no extraadrenal invasion

T3

Tumor of any size with local invasion but not invading adjacent organs*

T4

Tumor of any size with invasion of adjacent organs*

*Adjacent organs include kidney, diaphragm, great vessels, pancreas, spleen, and liver.

(N) Regional Lymph Nodes

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

Metastasis in regional lymph node(s)

(M) Distant Metastasis

M0

No distant metastasis

M1

Distant metastasis

Χαρακτηριστικά Επέκτασης

Local invasion

  • Only 30% confined to adrenal gland at presentation
    • Almost 20% present with IVC involvement
  • Common to spread via extracapsular infiltration locally into adjacent organs, including
    • Kidney
    • Diaphragm
    • Great vessels
      • Commonly extends into IVC
      • May occlude adjacent vessels
      • Pancreas
  • Spleen
  • Liver
  • Bone

Lymphatic metastases

  • Regional lymph nodes are
    • Paraaortic and periaortic nodes
    • Other retroperitoneal nodes

Hematogenous metastases

  • > 30% present with metastases, commonly to
    • Liver
    • Lung

Κατηγοριοποίηση (Ιστολογικοί Τύποι)

Histological Classification

  • Differentiated are usually functioning tumors
  • Anaplastic are rarely hormone producing

Hormonal: ~ 60% hormone producing

  • Clinical syndromes with functioning tumors
    • Hypercortisolism: Cushing syndrome
      (30-40%, most common)
  • Adrenogenital syndrome
  • Virilization in females
  • Feminization in males
  • Precocious puberty
  • Hyperaldosteronism
    • Primary (Conn syndrome)