Metastatic Adrenocortical Carcinoma: a Single Institutional Experience

Owen, Dwight H.; Patel, Sandipkumar; Wei, Lai; Phay, John E.; Shirley, Lawrence A.; Kirschner, Lawrence S.; Schmidt, Carl; Abdel‐Misih, Sherif; Brock, Pamela; Shah, Manisha H.; Konda, Bhavana

doi:10.1007/s12672-019-00367-0

Cited by 15 publications

(25 citation statements)

References 46 publications

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“…Koh et al (21) documented partial remission after embolization of a solitary liver lesion but no survival benefit. Owen et al (22) suggested from data of 6 patients that TACE or SIRT for liver metastases may contribute to better survival of their patients. Cazejust (23) et al achieved stabilization or radiological regression in the majority of their patients in a larger series of 26 cases, but complete response was not achieved.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Complete Necrosis of a Large Adrenocortical Cancer and Liver Metastases Achieved by Selective Arterial Embolization: A Case Study and Review of Literature

et al. 2021

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There is very limited experience regarding the interventional radiological treatment of adrenocortical cancer (ACC). We present the case of a 57-year-old female patient with a large, potentially unresectable left-sided ACC and two hepatic metastases. Both liver tumors were effectively treated by trans-arterial embolization (TAE), followed by TAE of the bulky primary tumor as a life-saving intervention necessitated by severe intratumoral bleeding. Surgical removal of the primary tumor revealed complete necrosis. The patient is considered tumor free after 3.5 years. To the best of our knowledge, this is the first report to show that even a primary ACC may be completely ablated by selective embolization, and the fourth to prove the curative potential of liver TAE for ACC metastases. This case highlights the potential of selective embolization in ACC treatment.

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Section: Discussionmentioning

confidence: 99%

Case Report: Complete Necrosis of a Large Adrenocortical Cancer and Liver Metastases Achieved by Selective Arterial Embolization: A Case Study and Review of Literature

et al. 2021

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“…These 6 cases had significantly longer median OS at 32 months, compared with 10 months in those patients with liver metastases who did not receive liver-directed therapies (p = 0.011). Although the results of this analysis are favorable and suggest a possible role for incorporating liver-directed therapies for patients with hepatic metastases, the sample number was small and bias in case selection may have contributed to perceived better outcomes [52]. Beyond this, only single case reports are available, which often describe extremely prolonged PFS or OS following TACE and SIRT [53,54].…”

Section: Local Therapiesmentioning

confidence: 96%

Advanced Adrenocortical Carcinoma (ACC): a Review with Focus on Second-Line Therapies

et al. 2020

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Advanced adrenocortical cancer (ACC) is a rare, highly aggressive malignancy, which typically has a poor prognosis. In advanced ACC, the overall trend is toward a short PFS interval following first-line systemic therapy, highlighting a clear need for improved second-/third-line treatment strategies. We conducted a review of the literature and relevant scientific guidelines related to systemic therapy for advanced ACC. Public indexes including PubMed/MEDLINE were searched. Treatment selection in the second-line setting is based on small phase 2 trials, case reports, and pre-clinical evidence. The best data available for initial second-line therapy selection supports the use of gemcitabine and capecitabine (G + C) or streptozotocin (S), both with or without mitotane. G + C is becoming increasingly recommended based on phase 2 clinical trial data in patients of good PS, due to the inferred superior PFS and OS from non-comparative trials. Alternatively, streptozotocin was better tolerated than EDP + M in the FIRM-ACT study and remains an option when warranted. Beyond this, further treatment approaches should be tailored to individual patient characteristics, utilizing a mixture of systemic therapies, local therapies, and enrolment in clinical trials where available. Additionally, the role of molecular stratification, predictive biomarkers, and immune checkpoint inhibitors in specific individuals, such as Lynch syndrome, is evolving and may become increasingly utilized in clinical practice. Advanced ACC necessitates a multidisciplinary approach and is best managed in a specialist center. Although there is no one definitive secondline treatment strategy, there are some favorable approaches, which require further validation in larger clinical trials.

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Section: Introductionmentioning

confidence: 99%

“…Adrenocortical carcinoma (ACC) is an uncommon, aggressive malignant tumor with an incidence of 0.5-2.0 cases per million inhabitants per year [1][2][3]. ACC has a bimodal age distribution, with small peaks in the first decades and a larger peak in the fourth to fifth decades of life [2,3]. Patients with functional ACC may present with excess steroid hormone production resulting in Cushing syndrome with or without virilization [2,3], while non-functional ACC patients may present with either symptoms related to tumor mass, such as abdominal discomfort, nausea, vomiting, and back pain, or discovered incidentally during radiological procedures [2,3].…”

Section: Introductionmentioning

confidence: 99%

Uncommon Metastasizing Site of Adrenocortical Carcinoma

Kumar

Nigam

Sharma

et al. 2021

Cureus

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Adrenocortical carcinoma (ACC) is a very rare tumor having a poor prognosis. Approximately 25% of these cases may present with metastases at the time of diagnosis. Common sites of metastasis are lung, liver, and lymph nodes. The bone metastases in ACC are less frequent. We report a case of a 35-year-old male presented with right parotid region swelling, rendered with a diagnosis of ACC metastasizing to the mandible ramus, which is an uncommon site.

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Metastatic Adrenocortical Carcinoma: a Single Institutional Experience

Cited by 15 publications

References 46 publications

Case Report: Complete Necrosis of a Large Adrenocortical Cancer and Liver Metastases Achieved by Selective Arterial Embolization: A Case Study and Review of Literature

Case Report: Complete Necrosis of a Large Adrenocortical Cancer and Liver Metastases Achieved by Selective Arterial Embolization: A Case Study and Review of Literature

Advanced Adrenocortical Carcinoma (ACC): a Review with Focus on Second-Line Therapies

Uncommon Metastasizing Site of Adrenocortical Carcinoma

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