![]() Other paraneoplastic syndromes or general tumor-related symptoms, such as weight loss, night sweats and fever are rare with ACC. ![]() Hypertension and hypokalemia can commonly be observed and are due to either aldosterone production (rare), secretion of mineralocorticoid precursors (11- deoxycorticosterone) or high levels of glucocorticoids overwhelming the renal 11-beta -HSD system leading to mineralocorticoid effects. Rare estrogen production causes gynecomastia in men and menstrual irregularities in women. Androgen production in male patients is usually clinically silent in female patients androgen excess often results in hirsutism, increased body hair growth, loss of scalp hair, menstrual abnormalities, and acne. The main symptoms of glucocorticoid production are Cushing’s syndrome with diabetes, weight gain, muscle weakness, decreased libido, psychiatric symptoms, and osteoporosis. Most hormonally active ACCs secrete androgens (DHEAS or testosterone) or cortisol or a combination of both. Symptoms due to hormone secretion depend on the hormones secreted (glucocorticoids, androgens, estrogens or mineralocorticoids). ![]() Patients present in one of three ways: 1) symptoms of hormone excess (40%), 2) abdominal pain/fullness or flank pain (40%), or 3) as an incidental finding as part of an unrelated workup (20%). ![]()
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