Multi-Target Approach to Metastatic Adrenal Cell Carcinoma.

Area of Science:

• Oncology
• Endocrinology

Background:

• Adrenal cell carcinoma (ACC) is a rare, aggressive endocrine tumor with a poor prognosis, frequently diagnosed at advanced stages.
• Current treatment standards include surgical intervention and mitotane, with etoposide, doxorubicin, and cisplatin plus mitotane approved as first-line therapy since 2012.

Observation:

• This case report details an advanced adrenal cell carcinoma in a pediatric patient presenting with a large adrenal mass, inferior vena cava thrombosis, and pulmonary embolism.
• The patient exhibited a large adrenal mass complicated by significant vascular invasion and metastatic disease.

Findings:

• A multi-approach therapeutic strategy was implemented to manage the extensive tumor burden and metastatic spread.
• This comprehensive treatment plan resulted in a prolonged survival of up to 5 years and 4 months for the patient.

Implications:

• This case highlights the potential efficacy of multi-modal therapy in managing advanced and complex adrenal cell carcinoma cases, even in young patients.
• Aggressive, tailored treatment strategies may offer extended survival benefits for patients with advanced adrenal cell carcinoma, challenging the typically poor prognosis.