Whole-Body Positron Emission Tomographic Scanning in Patients with Adrenal Cortical Carcinoma

Ahmed, Mohammed; Al-Sugair, Abdulaziz; Alarifi, Abdullah; Almahfouz, Abdulraof; Al-Sobhi, Saif S.

doi:10.1097/01.rlu.0000067512.53644.fb

Cited by 15 publications

(6 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…22-24 MRI, however, is superior in assessing the extent of vascular invasion, especially into the inferior vena cava with right adrenal tumors and should be obtained before a Estrogen or Androgen (20%-30%) [1][2][3]5,[8][9][10][11] Mineralocorticoid (rare) [26][27][28] Although it might help discriminate a benign adenoma from a malignant tumor, it cannot differentiate ACC from other tumors with high metabolic activities.…”

mentioning

confidence: 99%

Management of Endocrine Manifestations and the Use of Mitotane As a Chemotherapeutic Agent for Adrenocortical Carcinoma

Veytsman

Nieman

Fojo

2009

JCO

133

128

View full text Add to dashboard Cite

Adrenal cortical carcinoma (ACC) is a rare malignancy in which patients have poor overall 5-year survival. Patients with ACC can present with symptoms of hormone excess, including Cushing's syndrome, virilization, feminization, or—less frequently—hypertension with hypokalemia. In many patients with ACC, advanced disease at presentation precludes surgery or is followed by local relapse or distant metastatic disease that cannot be managed surgically. In these instances, chemotherapy is often tried, but its limited efficacy all too often leaves the problem of persistent hormonal excess. Physicians who treat patients with ACC and severe hypercortisolism should recognize that uncontrolled hormone production is a malignant disease, which has severe consequences that require aggressive management. Because chemotherapy benefits only a small percentage of patients, steroidogenesis inhibitors, including mitotane, ketoconazole, metyrapone, and etomidate, should be used singly or in combination even as chemotherapy is administered. Diligent management with frequent adjustments is required, especially in patients with chemotherapy-refractory tumors that continue to grow. In the absence of randomized, controlled trials, adjuvant use of mitotane remains controversial, although the authors of a recent case-control study argue for its use. Despite difficulty administering effective doses, most clinicians agree that mitotane should be used if the tumor cannot be removed surgically or should be used as adjuvant therapy if there is a high likelihood of recurrence. The option of long-term monotherapy is restricted to patients who tolerate mitotane and either experience a clinical response or are at high risk for recurrence. Recommendations are provided to help manage patients with this difficult disease and to improve the quality of their lives.

show abstract

mentioning

confidence: 99%

Management of Endocrine Manifestations and the Use of Mitotane As a Chemotherapeutic Agent for Adrenocortical Carcinoma

Veytsman

Nieman

Fojo

2009

JCO

133

128

View full text Add to dashboard Cite

show abstract

“…CT or MRI scanning of the abdomen and the chest is performed to defi ne the size of the tumor, to detect possible invasion into adjacent structures (including major blood vessels) and metastases to the liver or the mediastinum. As ACC has an active metabolism, whole-body PET-CT has a role in detecting distant metastasis beyond the abdomen and thorax, and in detecting tumor recurrence (5) .…”

Section: Discussionmentioning

confidence: 99%

A 12-year-old Chinese girl with Cushing syndrome and virilization due to adrenocortical carcinoma

Wong

Chan

et al. 2011

Journal of Pediatric Endocrinology and Metabolism

View full text Add to dashboard Cite

show abstract

“…The first published papers were case reports showing that ACC was a FDG-avid tumor and suggesting how FDG PET could be useful to perform a one-time whole-body evaluation [2,46]. A study, published by Becherer et al, evaluated ten patients with ACC, two of them at initial staging and eight at follow-up [7].…”

Section: Initial Staging; Recurrence Detectionmentioning

confidence: 98%

FDG PET in the Management of Patients with Adrenal Masses and Adrenocortical Carcinoma

et al. 2011

View full text Add to dashboard Cite

Adrenocortical carcinoma (ACC) is a rare tumor with aggressive behavior, high recurrence rate, and rapid evolution. Surgery is the only curative modality, while systemic treatments such as mitotane and chemotherapy associated to locoregional therapeutic tools remain as palliative options. Imaging has an important role in the management of patients with ACC both at diagnosis and during follow-up. First, it is necessary to characterize undetermined adrenal masses, selecting patients for surgery. Then, in case of malignancy, it is mandatory to assess disease extension, to detect early relapse during follow-up, and to evaluate treatment response. Computed tomography scan and magnetic resonance imaging are actually the most used techniques for these intents as they are widely available in clinical practice. (18)F-fluorodeoxyglucose positron emission tomography (FDG PET) is routinely used for other malignancies and, on the basis of published data, is also becoming a promising tool in the management of ACC. Not only is it a diagnostic tool complementary to morphological imaging in the characterization of adrenal masses and in tumoral lesions detection, but it can be also useful to evaluate tumor response to treatment. New tracers and indications for the clinical use of FDG PET in this specific disease still have to be evaluated to assess its role in clinical practice.

show abstract

Whole-Body Positron Emission Tomographic Scanning in Patients with Adrenal Cortical Carcinoma

Cited by 15 publications

References 7 publications

Management of Endocrine Manifestations and the Use of Mitotane As a Chemotherapeutic Agent for Adrenocortical Carcinoma

Management of Endocrine Manifestations and the Use of Mitotane As a Chemotherapeutic Agent for Adrenocortical Carcinoma

A 12-year-old Chinese girl with Cushing syndrome and virilization due to adrenocortical carcinoma

FDG PET in the Management of Patients with Adrenal Masses and Adrenocortical Carcinoma

Contact Info

Product

Resources

About