Biochemical Aspects of Adrenocortical Tumors

Background The biochemical investigation of a patient with signs or symptoms of an adrenocortical disorder is of great importance and should be performed early in the preoperative work-up. The purpose of this review is to highlight some of the useful biochemical diagnostic tools. Methods Hormone and steroid analysis in urine and serum. Results Urinary cortisol and aldosterone together with testosterone and oestradiol in serum remain useful screening tests in order to determine whether the tumor is overproducing steroid-hormones. Patients Spected having primary aldosteronism or nonhyperfunctioning adrencocortical tumors require a more specific endocrinological evaluation. In contrast to benign adrenocortical tumors, malignant ones may be diagnosed due to the presence of a pathological excretion of cortisol precursors. Conclusions In the event of a suspected adrenocortical tumor an abnormal hormone secretion should be established or ruled out. Furthermore, since a biochemical discrimination between benign and malignant adrenocortical tumors is possible such a procedure should also be performed.