Adrenocortical Ca

Adrenocortical Ca

Dr Nilesh Mahale 27 Apr 2010 13:59

55/F
May 09: Huge rt Adrenal mass on CT (9 cm*8 cm*3 cm) probably involving perirenal tissue
Radical Adrenalectomy done (although piece meal)
HPR: Adrenocortical Ca ( cells with nuclear atypia, necrosis and multiple mitoses)
Obviously patholgist couldn't comment on c/m and capsular penetration.
No adj treatment.
Mar 10: CT shows huge recurrence at rt suprarenal region ( 13 cm)
CxR: N
Gc fair, No bony tenderness
Deemed Inoperable this time sent to me.
I am attaching what NCI says on this
http://www.cancer.gov/cancertopics/pdq/treatment/adrenocortical/HealthProfessional/page9
Not a very common tumour and hence the ambiguity in management.
Chemo or RT ?

Re: Adrenocortical Ca

Rohit Malde 28 Apr 2010 23:44

Last month, i started a similar chap with mets adrenal ca with liver mets on single agent Mitotane.

Literature review says, optimum results with either single agent mitotane which gives a response rate 20-25%
or combination chemo with addition of cisplatin or doxorubicin, which may increase respionse rate to 35-40%
however at the expense of increased toxicity, myelosuppression,etc

Reserve Pall RT for a later date for pain control or hemorrhage.

cheers
Rohit