Successful long-term disease-free survival following multimodal treatments in a patient with a repeatedly recurrent refractory adrenal cortical carcinoma.
A 47-year-old male patient underwent surgery for a 10-cm adrenal cortical carcinoma. A large invasive adrenal mass was surgically removed en bloc with the right kidney and the lower lobe of the liver. Two months postoperatively, a 7-cm recurrent mass developed in the right psoas muscle. After a partial response was achieved by irradiation (40 Gy) and high-dose chemotherapy (carboplatin and etoposide) with peripheral blood stem cell transplantation, the patient underwent surgery with a wide excision of the psoas muscle. Twelve months after the initial surgery, an 8-cm rib metastasis developed and the patient again underwent surgery after a combination of irradiation (50 Gy) and chemotherapy (cisplatin and etoposide). The patient has been doing well without any evidence of recurrence for 5 years. Refractory or metastatic adrenal cortical carcinomas have been thought to be lethal, therefore, the present case provides support for multimodal treatments of refractory adrenocortical cancers.
Fujii
Yasuhisa
Y
Department of Urology and Reproductive Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan. y-fujii.uro@tmd.ac.jp
Kageyama
Yukio
Y
Kawakami
Satoru
S
Masuda
Hitoshi
H
Arisawa
Chizuru
C
Akamatsu
Hideki
H
Akashi
Takumi
T
Kihara
Kazunori
K
D018268:Adrenocortical Carcinoma / Q000175:diagnosis / Q000556:secondary / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy*; D011860:Radiography, Abdominal; D012008:Recurrence; D019616:Thoracic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome