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Complete response in a patient with stage IV adrenocortical carcinoma treated with adjuvant trans‐catheter arterial chemo‐embolization (TACE)
Author(s) -
Wong Eugene,
Jacques Sarah,
Bennett Michael,
Gorolay Vineet,
Lee Adrian,
Clarke Stephen
Publication year - 2018
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12759
Subject(s) - mitotane , medicine , etoposide , adrenocortical carcinoma , population , chemotherapy , oncology , gastroenterology , urology , surgery , environmental health
Adrenocortical carcinoma is a rare cancer, with estimate population incidence of 0.7–2.0 cases per 1 million each year. It also carries poor prognosis with estimated 5‐year survival of less than 15% of those with metastatic disease and has a poor response to cytotoxic treatment. A randomized controlled trial published in 2012 by Fassnacht et al . demonstrated improved progression‐free survival with first‐line etoposide‐doxirubicin‐cisplatin‐mitotane (EDP‐M) compared to first‐line streptozocin–mitotane in patients with stage III–IV disease. We report a case of a 25‐year‐old female diagnosed with adrenocortical carcinoma with liver and lung metastases treated with adjuvant EDP‐M chemotherapy. During her treatment, the patient experienced ongoing significant liver‐associated burden of disease, which prompted a trial of trans‐hepatic arterial chemoembolization with doxorubicin and mitomycin. The patient subsequently experienced complete remission of disease at 18 months with no fludeoxyglucose (FDG) avid lesions on PET/CT.