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原发性肾上腺皮质癌肝转移患者采用米托坦辅助治疗加经动脉化疗栓塞术和微波消融术实现长期部分缓解:一例报告

Long-term partial response in a patient with liver metastasis of primary adrenocortical carcinoma with adjuvant mitotane plus transcatheter arterial chemoembolization and microwave ablation: a case report.

作者信息

Deng Jianhua, Wei Lihui, Fan Qihuang, Wu Zoey, Ji Zhigang

机构信息

Department of Urology, Peking Union Medical College Hospital, Beijing, China.

Department of Medicine, Genetron Health (Beijing) Co. Ltd., Beijing, China.

出版信息

Front Oncol. 2023 May 29;13:1157740. doi: 10.3389/fonc.2023.1157740. eCollection 2023.

Abstract

Adrenocortical carcinoma (ACC) is a rare, heterogeneous, and aggressive malignancy with a generally poor prognosis. Surgical resection is the optimal treatment plan. After surgery, both mitotane treatment or the etoposide-doxorubicin-cisplatin (EDP) protocol plus mitotane chemotherapy have a certain effect, but there is still an extremely high possibility of recurrence and metastasis. The liver is one of the most common metastatic targets. Therefore, techniques such as transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA) for liver tumors can be attempted in a specific group of patients. We present the case of a 44-year-old female patient with primary ACC, who was diagnosed with liver metastasis 6 years after resection. During mitotane treatment, we performed four courses of TACE and two MWA procedures in accordance with her clinical condition. The patient has maintained the partial response status and has currently returned to normal life to date. This case illustrates the value of the practical application of mitotane plus TACE and MWA treatment.

摘要

肾上腺皮质癌(ACC)是一种罕见、异质性且侵袭性强的恶性肿瘤,预后通常较差。手术切除是最佳治疗方案。术后,米托坦治疗或依托泊苷-阿霉素-顺铂(EDP)方案联合米托坦化疗均有一定疗效,但复发和转移的可能性仍然极高。肝脏是最常见的转移靶点之一。因此,对于特定患者群体,可以尝试采用经动脉化疗栓塞术(TACE)和微波消融术(MWA)等治疗肝脏肿瘤的技术。我们报告了一例44岁原发性肾上腺皮质癌女性患者的病例,该患者在切除术后6年被诊断为肝转移。在米托坦治疗期间,我们根据她的临床情况进行了4个疗程的TACE和2次MWA手术。患者一直保持部分缓解状态,目前已恢复正常生活。该病例说明了米托坦联合TACE和MWA治疗实际应用的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffc3/10258337/050b1468a07d/fonc-13-1157740-g001.jpg

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