ミトタン＋EDP療法を施行した進行副腎皮質癌

Etoposide, doxorubicin and cisplatin plus mitotane in the treatment of advanced adrenocortical carcinoma : A case report

　36歳女性．腹部エコーにて左副腎腫瘍を指摘され当科初診．CTにて80×40×70mmの内部不均一に造影される腫瘍を認め，肝および肺に転移病変を認めた．左副腎摘出術を施行し，病理組織学的に副腎皮質癌と診断した（pT3N0M1）．ミトタン＋EDP（エトポシド・ドキソルビシン・シスプラチン）療法を行った．4コース施行後の画像評価で，転移病変の著明な縮小を認めた．腫瘍縮小効果は9か月間持続したが，8コース終了後に病勢悪化し，術後22か月に癌死した．

Abstract

A 36-year-old woman presented with a left adrenal tumor found incidentally by ultrasonography. Computed tomography (CT) revealed the 80×40×70mm heterogeneous enhanced tumor in the left adrenal gland. Multiple liver and lung metastases were also detected on CT. We performed adrenalectomy. The histopathological diagnosis of surgical specimen was adrenocortical carcinoma, stage IV (pT3N0M1). Systemic chemotherapy with etoposide, doxorubicin and cisplatin (EDP) plus mitotane was administered. The liver and lung metastases significantly decreased in size after 4 courses of chemotherapy with EDP plus mitotane and stable for 9months. The metastatic lesion progressed after 8 courses of chemotherapy and she died at 22 months after surgery (Rinsho Hinyokika 72 : 841-845, 2018).