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Primary Culture of Rat Adrenocortical Cells and Assays of Steroidogenic Functions

Primary Culture of Rat Adrenocortical Cells and Assays of Steroidogenic Functions

Published on: March 12, 2019

Adrenocortical Carcinoma with Hypercortisolism.

Soraya Puglisi¹, Paola Perotti¹, Anna Pia¹

¹Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, Regione Gonzole 10, Orbassano 10043, Italy.

Endocrinology and Metabolism Clinics of North America

|May 15, 2018

Summary

Adrenocortical carcinoma (ACC), a rare cancer, is often linked to hormone excess. Cortisol excess negatively impacts prognosis, making surgery and mitotane crucial treatments for managing this aggressive tumor.

Keywords:

Adrenocortical carcinoma Cortisol Cushing’s syndrome Mitotane

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Area of Science:

Endocrinology
Oncology

Background:

Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy.
ACC frequently presents with hormone excess syndromes, notably Cushing's syndrome and androgen hypersecretion.
Elevated cortisol levels are increasingly recognized as a detrimental prognostic factor in ACC.

Purpose of the Study:

To review the management of adrenocortical carcinoma, focusing on hypercortisolism.
To highlight the role of surgery and medical therapies in treating ACC with excess cortisol.

Main Methods:

Literature review of current treatment strategies for adrenocortical carcinoma.
Analysis of the impact of cortisol excess on ACC prognosis and treatment efficacy.

Main Results:

Radical surgery is the primary curative treatment for ACC when feasible, especially in cases with hypercortisolism.
Mitotane is the established first-line medical therapy for ACC, used postoperatively and for advanced/metastatic disease.
Combination therapy with agents like metyrapone can accelerate cortisol control due to mitotane's slow action.

Conclusions:

Effective management of hypercortisolism is critical for improving outcomes in adrenocortical carcinoma.
A multimodal approach combining surgery, mitotane, and adjunctive therapies offers the best strategy for ACC.
Addressing cortisol excess is a key component in the treatment of this rare endocrine tumor.