What role do hormonal assays play in the diagnosis and management of adrenal cancer?

Hormonal assays play a critical role in both the diagnosis and management of adrenal cancer by identifying hormone hypersecretion and guiding treatment decisions. In the diagnostic phase, biochemical evaluation through hormonal assays is essential to detect excess production of adrenal hormones such as cortisol, aldosterone, and androgens, which may indicate functional adrenal malignancy rather than a benign incidentaloma ¹. These assays typically include measurements of serum cortisol, plasma metanephrines, aldosterone-renin ratio, and androgens to establish hormone secretion profiles that suggest malignancy or functional tumour activity (Fassnacht et al., 2016).

During management, hormonal assays are used to monitor treatment response and detect recurrence. For example, normalization of hormone levels post-surgery indicates successful tumour removal, while persistent or rising hormone levels may signal residual or recurrent disease ¹. Additionally, hormonal evaluation helps tailor adjuvant therapies and guides surveillance strategies (Fassnacht et al., 2016).

In summary, hormonal assays are indispensable for confirming the functional status of adrenal tumours, differentiating malignant from benign lesions, and monitoring disease progression or remission in adrenal cancer patients. This integrated approach aligns with UK clinical guidelines and is supported by European expert consensus, ensuring comprehensive endocrine assessment throughout the patient pathway ¹ (Fassnacht et al., 2016).