Peritoneal metastases from adrenal cortical carcinoma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

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Citation: Tumori. 102(6):588-592, 2016 Dec 01PMID: 27716880Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *Adrenal Cortex Neoplasms/pa [Pathology] | *Adrenal Cortex Neoplasms/th [Therapy] | *Adrenocortical Carcinoma/pa [Pathology] | *Adrenocortical Carcinoma/th [Therapy] | *Chemotherapy, Cancer, Regional Perfusion | *Cytoreduction Surgical Procedures | *Hyperthermia, Induced/mt [Methods] | *Peritoneal Neoplasms/sc [Secondary] | *Peritoneal Neoplasms/th [Therapy] | Adrenal Cortex Neoplasms/di [Diagnosis] | Adrenocortical Carcinoma/di [Diagnosis] | Adult | Antineoplastic Agents, Alkylating/ad [Administration & Dosage] | Combined Modality Therapy | Female | Humans | Melphalan/ad [Administration & Dosage] | Peritoneal Neoplasms/di [Diagnosis] | Tomography, X-Ray Computed | Treatment OutcomeYear: 2016ISSN:
  • 0300-8916
Name of journal: TumoriAbstract: CONCLUSIONS: Rare diseases may have peritoneal metastases as a component of disease progression and profit from treatment with CRS plus HIPEC. The clinical features suggesting a favorable outcome from this combined treatment are relative sparing of small bowel and its mesentery, absence of disease outside the abdomen, low-grade disease, or limited extent of high-grade disease.METHODS: A profoundly symptomatic patient with extensive peritoneal metastases and local recurrence was treated using cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with melphalan as the chemotherapy agent.PURPOSE: Adrenal cortical carcinoma is a rare cancer that often presents in an advanced stage. Not only systemic metastases but also local recurrence and peritoneal metastases prevent long-term survival in these patients.RESULTS: Relative sparing of the small bowel within the abdomen and pelvis allowed a visible complete resection of all cancer. The HIPEC with melphalan was used to control microscopic residual disease. Similar surgical technology used in this patient could be used to prevent local recurrence and peritoneal metastases in patients at the time of resection of the primary adrenal cortical carcinoma.All authors: Sugarbaker PHFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-03-17
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Journal Article MedStar Authors Catalog Article 27716880 Available 27716880

CONCLUSIONS: Rare diseases may have peritoneal metastases as a component of disease progression and profit from treatment with CRS plus HIPEC. The clinical features suggesting a favorable outcome from this combined treatment are relative sparing of small bowel and its mesentery, absence of disease outside the abdomen, low-grade disease, or limited extent of high-grade disease.

METHODS: A profoundly symptomatic patient with extensive peritoneal metastases and local recurrence was treated using cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with melphalan as the chemotherapy agent.

PURPOSE: Adrenal cortical carcinoma is a rare cancer that often presents in an advanced stage. Not only systemic metastases but also local recurrence and peritoneal metastases prevent long-term survival in these patients.

RESULTS: Relative sparing of the small bowel within the abdomen and pelvis allowed a visible complete resection of all cancer. The HIPEC with melphalan was used to control microscopic residual disease. Similar surgical technology used in this patient could be used to prevent local recurrence and peritoneal metastases in patients at the time of resection of the primary adrenal cortical carcinoma.

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