Endocrine Abstracts

Introduction: Primary adrenocortical carcinoma (ACC) is a highly malignant but rare neoplasm. It can occur as a hormonally active or an inactive tumor. It is considered that about three-fourths of ACC cases are hormonally active, although they do not always give clinical symptoms. Mitotane (Lysodren) is registered by the FDA for the therapy of ACC, either for monotherapy or as a combined chemotherapy.

Case report: A 34-year-old woman, with a histopathological diagnosis of ACC (Weiss score 7 pts, Ki67-5%) after resection of the primary tumor in 2014, during the adjuvant mitotane therapy initiated in 2014 by an oncological center at the place of residence, was referred in 2017 to Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch because of the local recurrence of neoplasm with intraperitoneal dissemination. On the adimssion to our ward, the patient informed that she was pregnant. After the pregnancy was confirmed, the mitotane treatment was stopped (7 weeks’ gestation). The MRI examination performed at 30 weeks’ gestation revealed the progression of the disease. The patient gave birth to a healthy child in the 35 weeks’ gestation (Apgar score 10/10). After the delivery the mitotane therapy was resumed and the EDP chemotherapy was performed.

Conclusion: Female patients with ACC during mitotane therapy are required to use effective contraception (mechanical preferentially). However, the mitotane belongs to the D category (embryotoxic) in the FDA Pregnancy Categories, no fetal complications were found in this case.