Abstract

Adrenocortical carcinoma is a rare endocrine malignancy. Patients present with hormone excess or a local mass effect. The tumor is agressive and characterized by a high risk of recurrence even after complete resection. Recurrence rate (particularly local recurrence) is higher in laparoscopic adrenalectomy and most recurrences occur in the postoperative first two years. Because of the high recurrence rates, most patients need adjuvan treatment after radical resection. Three adjuvant therapotic approach have been suggested: Mitotane, mitotane plus chemotherapeutic agents and radiotherapy of the tumor bed. Adjuvant mitotane is the first line medical treatment but it is associated with some adverse events and in all patients a strict follow up is required because of the drug’s narrow therapeutic index. Adverse events are manageable through reduction of the mitotane dose. Patients with adrenocortical carcinoma should be followed up regularly at least 10 years after radical surgery.

Key words: Adrenal cancer, treatment, surgery, mitotane, chemotherapy, radiotherapy