Carcinoma suprarrenal gigante: Presentación de un caso

Toledo, Gustavo Emilio Muro; Guerra, Jorge Luis Losada; Pérez, Arelys Martín; Marín, Idel Reimundo Pérez

doi:10.4321/s0004-06142009000200008

Cited by 1 publication

(1 citation statement)

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“…Extension of ACC to surrounding structures and absence of a clear cleavage at preoperative diagnostic work-up should not represent a contraindication to an aggressive surgical approach: several experiences dealing with giant ACCs treated with multivisceral removal have been reported with satisfactory results [8,10,[12][13][14][15]. This surgical attitude has also been supported by larger consecutive series: data from the U.S. Adrenocortical Carcinoma Database show that 68 among 167 patients (40.7%) underwent adrenalectomy with some en-bloc resection of additional organs (AdEBR) and 26 patients among them had multiple organs removed (mainly kidney, left liver lobe, spleen, pancreatic tail); in this subgroup larger tumor (13 vs. 10 cm.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Transcatheter Arterial Embolization and En-Bloc Resection for Giant Non-Functioning Left Adrenocortical Carcinoma: A Case Report

Lucandri¹,

Mezzetti²,

Lirici³

et al. 2021

SCR

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Objective: To demonstrate efficacy and relative safety of compartment surgery in a case of large sized adrenocortical carcinoma (ACC), whenever associated with preoperative transcatheter arterial embolization (TAE) and adjuvant treatment with mitotane. Introduction: ACC is a rare illness; non-functioning lesions account for 40-55% of patients, may reach a large size, and show a clear attitude to infiltrate neighbouring organs. Case Report: Middle aged male visited for a huge left abdominal mass; contrast CT scan showed origin from the left adrenal lodge and possible extension of the tumor to surrounding structures. Preoperative adrenal work-up confirmed non-functioning nature of the adrenal mass. In order to allow a safe compartment excision and to decrease blood loss, preoperative angiography and TAE was performed. Patient underwent en-bloc resection of the mass, together with nephrectomy and distal splenopancreasectomy. No postoperative transfusions were required. Patient received adjuvant therapy with mitotane for 36 months since surgery, without any sign of tumor recurrence. Conclusion: An aggressive surgical approach seems justified also in locally advanced and infiltrating ACC; compartment resection is mandatory in order to obtain adequate resection margins. Preoperative TAE decreases intraoperative blood loss and need for transfusions. Adjuvant treatment with mitotane may contribute to reach remarkable disease-free survival.

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Section: Discussionmentioning

confidence: 99%