Adrenal gland and paraganglia
Adrenocortical carcinoma
Staging of adrenocortical carcinoma

Author: Pallav Gupta, M.D. (see Authors page)

Revised: 19 January 2016, last major update September 2013

Copyright: (c) 2002-2016,, Inc.

Table of Contents
Definition / general
Cite this page: Staging of adrenocortical carcinoma. website. Accessed December 12th, 2017.
Definition / general
Staging system proposed by MacFarlane, modified by Sullivan and Henley
  • Stage 1: confined to gland, 5 cm or less
  • Stage 2: confined to gland, more than 5 cm
  • Stage 3: extends outside gland without involving adjacent organs, any size
  • Stage 4: distant metastasis or involvement of adjacent organs

TNM Staging system from AJCC, 7th edition
  • This TNM and stage grouping are for adrenal cortical carcinoma only, and were created in AJCC's 7th edition
  • It is not intended for adrenal medullary tumors, adenomas or neuroblastoma

Primary tumor (T)
  • TX: primary tumor cannot be assessed
  • T0: no evidence of primary tumor
  • T1: tumor 5 cm or less in greatest dimension, no extra-adrenal invasion
  • T2: tumor greater than 5 cm, no extra-adrenal invasion
  • T3: tumor of any size with local invasion, but not invading adjacent organs*
  • T4: tumor of any size with invasion of adjacent organs*

    *Adjacent organs are kidney, diaphragm, great vessels, pancreas, spleen and liver

Regional lymph nodes (N)
    Regional lymph nodes are aortic (para- and peri-aortic) and retroperitoneal NOS
  • NX: regional lymph nodes cannot be assessed
  • N0: no regional lymph node metastasis
  • N1: metastasis in regional lymph node(s)

Distant metastasis (M)
  • M0: no distant metastasis
  • M1: distant metastasis

Stage grouping
  • I - T1 N0 M0
  • II - T2 N0 M0
  • III - T1-T2 N1 M0 or T3 N0 M0
  • IV - M1 Any T any N or T4 N0/N1 M0 or T3 N1 M0