Clinical characteristics and treatment outcome of patients with adrenocortical carcinoma

master's thesis

• Author: Aude Mugisha
• Mentor: Darko Kaštelan (mentor)
• Committee member: Ivana Pavlić-Renar (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Darko Kaštelan (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Adrenocortical carcinoma is a very rare and aggressive endocrine tumor, which
generally conveys poor overall 5-year survival. Worldwide incidence is estimated at 1-2
million /year. Patients who suffer from ACC can present with symptoms of hormone
excess, including Cushing’s syndrome, virilization, feminization and less frequently
hypertension associated with hypokalemia.
In almost all cases, histopathological research can distinguish between
adrenocortical adenoma and carcinoma, using one of the international classification
methods. Other diagnostic techniques include hormone work up and imaging methods.
Radical surgery is considered the therapy of choice in the first stages of ACC, and when
surgery is not feasible, after incomplete resection or for metastatic disease, adjuvant
mitotane is added. Control of excessive hormone production is a vital part of
management in all patients.
Nevertheless, despite complete resection, there are high recurrence rates.
Management of recurrent ACC should take place in a specialist center and the individual
biology of each case of recurrence must be considered when making treatment decisions.
Early detection of recurrent disease is important as well as close follow up with clinical
examination and imaging. Liver, pulmonary and bone metastasis are most often involved
in systemic recurrence and management usually consists of mitotane, with or without
combination chemotherapy. Surgical resection only plays a limited role in systemic
recurrence, and only in selected patients. Unfortunately, treatment for this aggressive
tumor is still ineffective.

• Keywords: adrenocortical carcinoma; drug therapy; treatment outcome
• Language: english
• URN:NBN: urn:nbn:hr:105:669084
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-11-20 09:53:33