We do not know exactly what causes most adrenal cortical tumors. Over the past several years, experts have made great progress in understanding how certain changes in a person's DNA can cause cells in the adrenal gland to become cancerous. DNA is the molecule that carries the instructions for nearly everything our cells do. We usually look like our parents because they are the source of our DNA. However, DNA affects more than the way we look. It also determines our risk for developing certain diseases, including some types of cancer.
Some genes (parts of our DNA) control when our cells grow and divide. Some genes that promote cell division are called oncogenes. Other genes that slow down cancer cell division or make them die are called tumor suppressor genes. We know that cancers can be caused by DNA mutations (changes) that turn on oncogenes or turn off tumor suppressor genes. Some people with cancer have DNA mutations they inherited from a parent, which increase their risk for developing the disease. But most DNA mutations that are seen in cancers happen during life rather than having been inherited. These mutations may result from exposure to radiation or carcinogens (cancer-causing chemicals). But most of these mutations happen for no apparent reason.
The DNA mutations that cause tumors in people with the genetic syndromes discussed in the previous section have been identified. Overall though, these rarely cause adrenal cortical cancer. However, because adrenal cancer is so rare, if you have adrenal cancer, it may be worthwhile to consider genetic testing to find out if you have one of these syndromes. If you do, you (and your family members) may have an increased risk to develop other cancers also.
The Li-Fraumeni syndrome is caused by inherited mutations that inactivate the p53 tumor suppressor gene. This syndrome causes few cases of adrenal cancer in adults (1 of every 20), but is often the cause of adrenal cancer in children. In fact, about 8 of every 10 cases of adrenal cancer in children are caused by Li-Fraumeni syndrome. Many other adrenal cancers have also been found to have abnormal p53 genes that were acquired after birth (not inherited).
Last Revised: 02/25/2015