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Recurrent adrenocortical carcinoma after laparoscopic resection
Angelika Schlamp1, Klaus Hallfeldt, Ullrich Mueller-Lisse
1Medizinische Klinik Innenstadt, University Hospital, Munich, Germany. angelika.schlamp@med.uni-muenchen.de
Nature Clinical Practice. Endocrinology & Metabolism
|January 24, 2007
Summary
Adrenocortical carcinoma recurrence was managed with surgery, radiation, and mitotane. Despite initial treatment, the patient developed metastatic disease requiring further interventions including polychemotherapy.
Area of Science:
- Oncology
- Endocrinology
- Surgical Pathology
Background:
- A 53-year-old male presented with flank pain and a left adrenal mass.
- Initial investigations ruled out hormonal imbalances and Cushing's syndrome.
- Histologic examination confirmed adrenocortical carcinoma.
Observation:
- Post-operative imaging showed no signs of disease after laparoscopic adrenalectomy.
- The patient experienced a recurrence of left-sided flank pain 11 months post-surgery.
- Follow-up imaging revealed local tumor recurrence and later lymph node metastasis.
Findings:
- Recurrent adrenocortical carcinoma was treated with repeat surgery, radiation, and mitotane.
- A subsequent lymph node metastasis was surgically removed, with mitotane treatment resumed.
- Progressive metastatic disease was identified, necessitating polychemotherapy.
Implications:
- This case highlights the potential for recurrence and metastasis in adrenocortical carcinoma.
- Multimodal treatment approaches, including surgery, radiation, and systemic therapy, are crucial.
- Adjuvant therapies like mitotane play a role in managing recurrent disease.
