Published online Feb 10, 2018. doi: 10.5306/wjco.v9.i1.20
Peer-review started: September 7, 2017
First decision: October 30, 2017
Revised: November 5, 2017
Accepted: December 4, 2017
Article in press: December 4, 2017
Published online: February 10, 2018
Processing time: 157 Days and 3.5 Hours
Adrenocortical carcinoma (ACC) is a rare malignancy with generally poor outcomes and limited treatment options. While surgical resection can be curative for early local disease, most patients present with advanced ACC owing to nonspecific symptoms. For those patients, treatment options include systemic chemotherapy and locoregional therapies including radiofrequency ablation and transarterial chemoembolization. We present the first reported case of utilizing yttrium-90 microsphere selective internal radiation therapy (SIRT) in combination with first line EDP-M (Etoposide, Doxorubicin, Cisplatin, Mitotane) chemotherapy and debulking surgical primary tumor resection for treatment of metastatic ACC. Stable complete radiologic response has been maintained after twelve months with resolution of clinical symptoms. These findings prompt the need for further consideration and studies to elucidate the role of SIRT in combination with systemic and surgical treatment for metastatic ACC.
Core tip: Adrenocortical carcinoma (ACC) is a rare malignancy with generally poor outcomes and limited treatment options. Approximately 70% of ACC patients have unresectable stage III or IV disease on initial presentation. Yttrium-90 microsphere selective internal radiation therapy was applied toward hepatic metastases for a patient with metastatic ACC in combination with first line chemotherapy and debulking surgical primary tumor resection. A stable complete radiologic response has been maintained for twelve months with resolution of clinical symptoms.