Goto Takako, Miyako Kenichi, Kuromaru Ryuichi, Ihara Kenji, Torisu Hiroyuki, Sanefuji Masafumi, Nagamatsu Rie, Hara Toshiro
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ; Present: Department of Pediatrics, Beppu Medical Center, Beppu, Japan.
Clin Pediatr Endocrinol. 2008;17(3):71-4. doi: 10.1297/cpe.17.71. Epub 2008 Aug 8.
This report concerns control of adrenocortical carcinoma in a 4-yr-old boy by adjuvant mitotane therapy. He presented precocious puberty and was diagnosed with adrenocortical carcinoma. He underwent surgical resection, and adjuvant mitotane therapy was initiated, leading to a final dose of 5.0 g/day. Despite monitoring of the plasma mitotane level, encephalopathy developed 5 mo after initiation. Although he recovered from the encephalopathy, careful follow-up of his growth and development is necessary. On the other hand, he has been free of recurrence and metastases for 3 yr since discontinuation of mitotane. A high dose of mitotane is potentially effective as an adjuvant chemotherapy for adrenocortical carcinoma, although optimal and safe usage needs to be established for children.
本报告涉及一名4岁男孩通过米托坦辅助治疗控制肾上腺皮质癌的情况。他出现性早熟，被诊断为肾上腺皮质癌。他接受了手术切除，并开始进行米托坦辅助治疗，最终剂量达到5.0克/天。尽管监测了血浆米托坦水平，但在开始治疗5个月后出现了脑病。虽然他从脑病中康复，但仍有必要对其生长发育进行密切随访。另一方面，自停用米托坦以来，他已3年无复发和转移。高剂量米托坦作为肾上腺皮质癌的辅助化疗可能有效，尽管需要为儿童确定最佳和安全的用法。
