Endocrine Abstracts

Introduction: Primary adrenal carcinoma is a very rare pathology, its treatment is fundamentally surgical and adjuvant treatment with mitotane can prevent recurrences. The prognosis varies depending on the patient, the stage and the histopathological diagnosis. We present the case mix of patients diagnosed with adrenal cortex carcinoma in our center between 2012-2022 and review the management of this pathology.

Patients and Methods: Retrospective study on adult patients diagnosed with adrenal carcinoma in our center between 2012-2022. We include hormonal study, imaging tests, treatment, histopathological findings and evolution. In carrying out this work we have followed the ethics rules for publication, informed consent has been obtained from the patients and it has been approved by the corresponding ethics committee.

Results: We included eight patients (Table 1), five women and three men, with a mean age of 47 years (range 25-68 years). Three consulted for locoregional symptoms, 4 for functional syndrome and one was diagnosed incidentally. The majority had hyperproduction of sex hormones and cortisol and one case turned out to be non-functioning. Half of the tumors were located on the left adrenal gland and the other half on the right. Two patients had metastasis at diagnosis and one case had a second concomitant primary lung neoplasia. The sites of metastases were liver, lung and bone. Of the eight cases presented, 6 patients underwent adrenalectomy with radical intent. Surgery was not performed in the two patients with stage IV disease; In both cases, metastasis of adrenal carcinoma was confirmed by biopsy of liver metastasis. The patient with a second primary lung tumor first underwent adrenalectomy and then resection of the lung tumor. Regarding the histological study of the surgical specimens, in all cases it was described the Weiss score and the Ki67. Three were low grade and three were high grade. Five patients received treatment with mitotane, due to high grade to prevent recurrence (3 cases) or due to advanced stage of the disease (2 cases). One patient received chemotherapy with EDP (etoposide, doxorubicin and cisplatin) with partial response. In follow-up, until 2022-2023, four patients are in remission, three Patients presented a recurrence of the disease and 3 patients died (one after a recurrence and the other two -stage IV- one month and one year after diagnosis).