title: [Adrenal carcinoma: 7 year disease free survival after complete primary tumor resection and repeated resection of local-regional and distant recurrences. Review after one case with poor initial life expectancy].
abstract: OBJECTIVE
  We report the case of a female patient with adrenal carcinoma who had undergone surgery and presented with local-regional and distant recurrences, emphasizing the importance of the aggressive surgical treatment to achieve long-term survival which is unexpected sometimes. Currently, it represents the gold standard and all cases should be reported to stimulate other groups to work in this line.
  
  
  RESULTS
  We report the case of a 29-year-old female patient who consulted for left flank pain, being diagnosed of an adrenal tumor by radiological tests; she underwent surgical excision of a left adrenal carcinoma (stage II). Later on she presented with local-regional recurrences (2 times) and distant metastases (liver) undergoing excision in three procedures. Currently, the patient is alive and free of disease 7 years after diagnosis.
  
  
  CONCLUSIONS
  Adrenal cancer recurrences have been considered lethal in the short-term. Nevertheless, an aggressive surgical approach of local recurrences and metastasic disease may significantly prolong patient's survival and, sometimes, leave the patient disease free several years after the diagnosis of the primary tumor.
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Regional Universitario de Málaga Carlos Haya, Málaga, España. cprptot@hotmail.com
authors.forename: César P
authors.initials: CP
authors.lastname: Ramírez Plaza
authors.forename: Julio
authors.initials: J
authors.lastname: Santoyo Santoyo
authors.forename: Marta E
authors.initials: ME
authors.lastname: Domínguez López
authors.forename: Carmen
authors.initials: C
authors.lastname: Eloy-García Carrasco
authors.forename: Manuel
authors.initials: M
authors.lastname: Cobo Dols
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Suárez Muñoz
authors.forename: José L
authors.initials: JL
authors.lastname: Fernández Aguilar
authors.forename: Agustín
authors.initials: A
authors.lastname: de la Fuente Perucho
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000601:surgery*; D000328:Adult; D002277:Carcinoma / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D012086:Reoperation; D013997:Time Factors