Case Reports

Management of adrenocortical carcinoma: case report

Diki Arma Duha , Hendy Mirza

Diki Arma Duha
Department of Urology, Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. Email: dikiarmaduha@gmail.com

Hendy Mirza
Department of Urology, Persahabatan Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
Online First: July 31, 2021 | Cite this Article
Duha, D., Mirza, H. 2021. Management of adrenocortical carcinoma: case report. Indonesia Journal of Biomedical Science 15(1): 96-99. DOI:10.15562/ijbs.v15i1.316


Background: Adrenocortical carcinoma (ACC) is a rare malignancy. Currently, surgical resection offers the best chance of cure with localized tumors. However, multimodal therapy, including systemic chemotherapy and radiation therapy, is often required for locally advanced and metastatic disease to decrease these high recurrence rates.

Case presentation: A 42-year-old male patient was referred from an internist due to mass in left adrenal. Solid mass with calcification on left adrenal gland within size 9 x 11,8 x 11,5 cm was found in MSCT. We performed complete surgical resection (adrenalectomy), and results from pathology anatomy were ACC functional T2N1M0 (stage 3). The patient has planned eight times chemotherapy with etoposide and carboplatin, but he decided to stop the treatment after six times due to no constitutional complaint. We found no residual mass on follow up six months after operation and patient demonstrated an excellent clinical outcome after one year

Conclusion: We perform open adrenalectomy and after surgery mitotane plus etoposide, cisplatin, doxorubicin (EDP) were administered as first-line therapy, but we only did chemotherapy with etoposide and carboplatin because mitotane was not covered by patient insurance. We chose not to perform radiation therapy due to the lesser benefit of adjuvant radiotherapy, as evidenced by many studies regarding recurrence-free survival and overall survival. In our case, adrenocortical carcinoma treated with open adrenalectomy combined with 6 times chemotherapy used etoposide and carboplatin demonstrated an excellent clinical outcome after 1 years.

References

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