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Adrenal cortical carcinoma

1966; Elsevier BV; Volume: 41; Issue: 4 Linguagem: Inglês

10.1016/0002-9343(66)90219-1

1555-7162

Adolph M. Hutter, Donald E. Kayhoe,

Pituitary Gland Disorders and Treatments

The clinical features of 138 patients with adrenal cortical carcinoma treated with ortho para'DDD (o,p'DDD) were analyzed and compared with those of the forty-eight published cases. This tumor appears at all ages and with equal frequency on the left and right sides. Female subjects comprised 68 per cent of the present series, although analysis of various tumor registries reveals that adrenal carcinoma occurred more frequently in male subjects. Local invasion was frequent. The most common sites of distant metastases were the lungs and liver. The major endocrine syndromes were Cushing's syndrome and virilization, the most common nonendocrine features were pain and abdominal mass. There was a median lag of eight months between the onset of symptoms and diagnosis. More than 60 per cent of the patients had increased urinary 17-ketosteroid excretion and a similar proportion had increased urinary 17-hydroxycorticosteroid excretion. Survival curves suggest that female patients live longer than male patients and that patients with normal steroid excretion live longer than those with increased excretion. Primary treatment of adrenal carcinoma should be surgical removal of the tumor whenever possible. o,p'DDD has recently assumed an important role in treating patients for whom surgery is no longer indicated.