Journal of Korean Endocrine Society 2003;18(2):232-238.
Published online April 1, 2003.
A Case of Adrenal Cortical Carcinoma with Liver Metastasis.
Hyun Joo Lee, Myung Soo Kim, Hyo Kyoung Park, Dae Jung Kim, Yu Mie Rhee, Chul Woo Ahn, Jae Hyun Nam, Bong Soo Cha, Young Duk Song, Sang Won Han, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
2Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
Abstract
An adrenal cortical carcinoma is a rare malignancy associated with poor prognosis. On diagnosis, most patients present with large tumor masses, which are often detected at an advanced stage. The most effective treatment is a complete resection, which is the only curative treatment for adrenal cortical carcinomas. The most important prognostic factor is a successful resection of the primary tumor, as long as it is low-grade and has not spread to distant sites. However, with advanced adrenal cortical carcinomas, with distant metastasis, there is no strict effective treatment program, and the prognosis is poor. The case of a 50-year-old female patient, presenting with an adrenal cortical carcinoma and Cushing's syndrome, who had a long-term survival of 78 months, is reported. The mass was completely resected on diagnosis, but 16 months later liver metastasis was discovered. She had received chemotherapy, with cisplatin, etoposide and bleomycin, for the liver metastasis for a period of 15 months, but with no response, furthermore, the size had increased after 10 months. Afterward, she received her 10th session of intrahepatic artery cisplatin chemotherapy and her 3rd hepatic artery embolization. Although the patient had a large degree of liver metastasis, this was tolerated. The tumor mass is presently not aggravated, and she still survives after 78 months.
Key Words: Adrenal cortical carcinoma, Liver metastasis, Long-term survival


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