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Long-term survival in recurrent adrenocortical cancer
  1. Md Shuayb1,
  2. Arunangshu Das1 and
  3. Mirza Nazim Uddin2
  1. 1Square Oncology & Radiotherapy Centre, Square Hospital, Dhaka, Bangladesh
  2. 2Square Hospital, Dhaka, Bangladesh
  1. Correspondence to Dr Md Shuayb, Square Oncology & Radiotherapy Centre, Square Hospitals Ltd. Dhaka, 1205, Bangladesh; m.shuayb{at}yahoo.co.uk

Abstract

Adrenocortical carcinoma (ACC) comprises approximately 0.02% of all malignant tumours, which are a very small fraction of a group of cancers that affect in 0.7 to 2 in 1 000 000 people per year. Recurrence is very common even after complete resection and prognosis is poor. We report a case of a sporadic form of ACC found in a 41-year-old Asian Bangladeshi man. His tumour was surgically excised completely with negative margins and he did not receive any adjuvant therapy. Four years later, adrenal adenoma was developed at his opposite side which was also excised. Then after a total duration of 7 years, he developed recurrence in both adrenal glands and extensive metastases to bilateral lungs, liver and abdominal wall. As per FIRM-ACT study, we started treatment with etoposide, doxorubicin, cisplatin plus mitotane (EDP-M), and the patient responded dramatically. He became symptom free and achieved radiological partial response just on completion of three cycles. To our knowledge, this is the first case of ACC in Bangladesh published in the literature. Managing rare cancers is always challenging due to the fact that clinicians lack practical experience in it. We believe that patient with a rare cancer with poor prognosis like ACC may also survive long, and extensive metastases can also be controlled.

  • adrenocortical carcinoma
  • adrenal tumor
  • mitotane
  • rare tumor
  • survival
  • bangladesh

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Footnotes

  • Contributors MS was responsible for acquisition of clinical information from the patient and wrote the whole manuscript. AD was the primary oncologist and involved in the clinical management of the patient. MNU coordinated clinical management. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Next of kin consent obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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