Causes and risk factors
No established risk factors are available for adrenal cancer. This
is due to the fact that they are very rare which has made
epidemiological studies unfruitful and difficult.
At the genetic level adrenal neoplasms show the following
- Mutation or loss of p53 tumor suppressor gene which is
present on chromosome 17 (17p). Adrenocortical cancer is a
frequent occurrence in Li-Fraumeni
syndrome which harbors a germline mutation in TP53.
- Frequent loss of heterozygocity on chromosomes 11p and 13q.
Adrenocortical cancer is seen in Beckwith-Wiedemann syndrome
which involves a mutation in 11p15.
Risk for developing the disease is increased in men who smoked
more than 25 cigarettes daily (odds ratio 2:0; 95% confidence
Women who used
oral contraceptives, especially before age 25 have
an increased risk in developing adrenocortical cancer (odds ratio
1:8; 95% CI1.0?3.2).
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Suggestions have been made that adrenal hyperplasia predisposes
adrenocortical cancer. However, a definitive proof for a
hyperplasia-to-adenoma-to-carcinoma sequence, which occurs with
colonic neoplasms, is lacking.