Adrenal cortical cancer
Diagnosing ACC can be difficult. This is because there are many other conditions that can cause the same symptoms. Most of them are much more common than ACC.
Find out about the symptoms of ACC
Your GP will refer you to a specialist for tests if you have symptoms that could be caused by cancer. The tests are to diagnose whether you have cancer, and what type. Tests also find out the size of your cancer and whether it has spread. This is the stage of your cancer.
You have blood and urine tests to check your general health and to find the cause of your symptoms. You might have blood tests to check:
levels in your blood
the number of , and
how well your and are working
You may also have a 24 hour urine collection. This test measures the levels of certain hormones in the urine.
Your doctor may also ask you to have a salivary test to check the levels of hormones in your body.
Find out more about blood tests
Scans of your body can show where a tumour is, how big it is and whether it has spread anywhere else. This can help to stage the cancer.
The tests you might have include:
CT scan
MRI scan
PET-CT scan
CT (or CAT) scan stands for computed (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body.
You usually have a CT scan of your chest and tummy (abdomen).
Read more about having a CT scan
MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body. It usually takes between 15 and 90 minutes.
Find out more about having an MRI scan
A PET-CT scan combines a CT scan and a PET scan. The PET scan uses a mildly drug to show up areas of your body where cells are more active than normal.
A PET-CT scan can help doctors decide whether you can have an operation to remove ACC.
Find out more about having a PET-CT scan
A biopsy means taking a sample of cells or tissue and looking at it under a microscope.
You don’t usually need a biopsy of the adrenal glands to diagnose ACC. This is because blood tests, urine tests and scans are more useful than a biopsy in diagnosing ACC.
Your doctor might take a biopsy from other parts of your body. This can show whether ACC has spread to other parts of your body.
Read more about having a biopsy
The stage of ACC tells you about the size of the tumour and whether it has spread. This helps your doctor decide what treatment you need.
In the UK, doctors usually use the TNM system to stage ACC. TNM stands for Tumour, Node, Metastasis.
T describes the size of the tumour
N describes whether there are any cancer cells in the
M describes whether the cancer has spread to a different part of the body
The doctor gives each factor (T, N and M) a number, depending on how far the cancer has grown.
Your doctor may also use a staging system developed by the European Network for the Study of Adrenal Tumours (ENSAT). Ask your doctor to explain the stage of your cancer and what that means for you.
There are four T stages, from T1 to T4.
T1 means the tumour is 5 cm or less.
T2 means the tumour is bigger than 5 cm.
T3 means the tumour has grown into the surrounding tissues.
T4 means the tumour has grown into nearby organs or blood vessels such as the vena cava.
There are two N stages, N0 and N1.
N0 means there are no cancer cells in the lymph nodes.
N1 means there are cancer cells in the lymph nodes.
There are two M stages, M0 and M1.
M0 means there is no sign of cancer spread.
M1 means the cancer has spread to other parts of the body, such as the liver and lungs.
The main treatments for ACC are surgery and chemotherapy.
Find out more about the different types of treatment for ACC
Coping with a diagnosis of cancer can be difficult, especially when you have a rare cancer. There are things you can do and people who can help you cope with a diagnosis of cancer.
Read about the emotional, physical and practical effects of cancer
Last reviewed: 11 Mar 2025
Next review due: 11 Mar 2028
The main treatment for adrenal cortical cancer (ACC) is surgery. If ACC comes back or spreads, doctors call this advanced ACC. Treatment for advanced ACC is usually chemotherapy.
Adrenal cortical cancer is also called adrenocortical carcinoma. It is a very rare type of adrenal gland tumour. It starts in the outer layer (cortex) of the adrenal gland.
It can be hard to cope with cancer and its treatment. This can be especially difficult if you have a rare cancer or a rare type of leukaemia or lymphoma.
Find out about tests to diagnose cancer and monitor it during and after treatment, including what each test can show, how you have it and how to prepare.
If something doesn’t look or feel quite right, speak to your doctor or GP. Spotting cancer early saves lives.
Adrenal cortical cancer (ACC) is very rare and also known as adrenocortical carcinoma. ACC starts in the outer layer of the adrenal glands, which are next to the kidneys.
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