title: 5th International ACC Symposium: The New Genetics of Benign Adrenocortical Neoplasia: Hyperplasias, Adenomas, and Their Implications for Progression into Cancer.
abstract: Genetic tools for the analysis of human tumors have developed rapidly over the past 20 years. Adrenocortical neoplasms have been subject to multiple analyses using these new genetic tools. Analysis of adrenocortical carcinomas (ACCs) has been complicated by the fact that these tumors tend to exhibit multiple somatic abnormalities, so that identifying driver mutations is complex task. In contrast, benign adrenocortical neoplasms have proven to be a fertile ground for the identification of the genetic causes of adrenocortical adenomas, as well as a variety of adrenocortical hyperplasia. Analysis of cortisol-producing adrenocortical adenomas has revealed alterations leading to enhanced signaling through the cAMP-dependent protein kinase (PKA) pathway. In contrast, macronodular cortisol-producing neoplasias have been shown to result from mutations in the ARMC5 gene, whose function is not yet quite so clear. In contrast, adrenal tumors resulting in excess production of the blood pressure hormone aldosterone almost always result from abnormalities of calcium handling, both in single adenomas and in bilateral hyperplasias. In both cases, there is elevation of a signaling pathway responsible both for hormone secretion and for gland growth and maintenance, thus confirming the linkage of these two output of cellular physiology. The connection between the benign hyperplasia observed in these states and adrenocortical carcinogenesis is not nearly as clear, although genetic studies are beginning to elucidate the relationship between benign and malignant tumors of this gland.
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, The Ohio State University Wexner Medical Center, 460 W 12th Ave, Rm 510, Columbus, OH, 43210, USA. Lawrence.Kirschner@osumc.edu.
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Kirschner
authors.affiliation: National Institute of Child Health and Human Development, National Institutes of Health, 31 Center Dr. Room 2A46 MSC 2425, Bethesda, MD, 20892-2425, USA. stratakc@mail.nih.gov.
authors.forename: Constantine A
authors.initials: CA
authors.lastname: Stratakis
mesh_terms: D000302:Adrenal Cortex / Q000473:pathology*; D000306:Adrenal Cortex Neoplasms / Q000235:genetics* / Q000473:pathology; D018246:Adrenocortical Adenoma / Q000235:genetics* / Q000473:pathology; D051186:Armadillo Domain Proteins; D003226:Congresses as Topic; D017868:Cyclic AMP-Dependent Protein Kinases / Q000235:genetics; D006801:Humans; D006965:Hyperplasia; D009154:Mutation; D015398:Signal Transduction; D025521:Tumor Suppressor Proteins / Q000235:genetics
chemical_list: C000590373:ARMC5 protein, human; D051186:Armadillo Domain Proteins; D025521:Tumor Suppressor Proteins; D017868:Cyclic AMP-Dependent Protein Kinases