Two Onc Docs
Adrenocortical Carcinoma
Podcast summary created with Snipd AI
Quick takeaways
- Adrenal cortical carcinomas can be functional or non-functional and their imaging characteristics help in determining their likelihood of being adrenal cortical carcinomas.
- Monitoring therapeutic levels of mitotane, a key drug for adrenal cortical carcinoma treatment, is important to prevent adrenal insufficiency and aldosterone deficiency.
Deep dives
Adrenal Cortical Carcinomas: Rare but Aggressive Tumors
Adrenal cortical carcinomas are rare tumors that can be functional or non-functional. Functional tumors can cause Cushing's syndrome or virilization. On imaging, adrenal tumors that are larger, have irregular borders, calcifications, invasion of surrounding structures, or lymph node enlargement are more likely to be adrenal cortical carcinomas. Additional evaluations include bone scan, CT chest abdomen pelvis, and hormonal tests. Staging is based on tumor size, local infiltration, lymph node involvement, and distant metastases. Surgery is the main treatment for stages one through three, while adjuvant therapy with mitotane is considered based on prognostic factors. Systemic therapy options are limited for unresectable or metastatic cases, with mitotane combined with EDP (etoposide, doxorubicin, platinum) being the preferred regimen.
