Adrenocortical carcinoma laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2] Mohammed Abdelwahed M.D [3]

Overview

Patients with functional adrenocortical carcinoma may have elevated concentrations of serum cortisol, aldosterone, testosterone or estrogen and reduced concentration of plasma renin and potassium.

Laboratory findings consistent with adrenocortical carcinoma are:

Hormonal disturbance	labs
Cortisol^[1]	Cortisol level ACTH (10 pg/mL) 24-hour urinary free cortisol Fasting serum cortisol at 8 AM following a 1 mg dose of dexamethasone at bedtime
Steroids^[2]	Adrenal androgens (DHEAS) Androstenedione Bioavailable testosterone should be measured in every patient. 17-hydroxyprogesterone Serum estradiol in men and postmenopausal women A recent study has shown significant differences in steroid hormones precursor and metabolite profiles in the urine of patients with ACC compared to patients with benign adrenal tumors.
Epinephrine^[3]	Metanephrine and normetanephrine in the plasma or 24-hour urine
Aldosterone^[4]	Low serum aldosterone concentrations, normal or high serum or urinary concentrations of aldosterone precursors