A CASE OF ADVANCED ADRENAL CANCER COMPLETELY REMOVED AFTER CHEMOTHERAPY

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A 45-year-old man who had hypertension and central obesity was diagnosed as having Cushing syndrome from examinations including hematologic study. And a tumor about 8cm in diameter was found in the right adrenal gland on CT scan, which was thought to be primary adrenal cancer. Although the tumor was encapsulated, it was adjacent to the kidney, liver, and inferior vena cava, and the tumor was in the height of its proliferation. Considered these findings, we decided that complete removal of the tumor by surgery was difficult and started preoperative chemotherapy with continuous administration of mitotane and 4 courses of etoposide. When a mild diminishing of the tumor and center necrosis of the tumor were identified by imaging methods, adrenectomy, associated resection of the right kidney, and partial hepatectomy were performed. Histopathological findings disclosed no invasion into the kidney and liver, so that the tumor was able to be removed completely.No definite protocols for the kinds of chemotherapeutic drugs and duration of administration have been established as preoperative chemotherapy as yet. In this case we carried out surgery at the time when some changes in the tumor were identified on CT, however, some protocol should be established hereafter.
日本臨床外科学会の論文