TY - JOUR
T1 - American association of clinical endocrinology disease state clinical review on the evaluation and management of adrenocortical carcinoma in an adult
T2 - A practical approach
AU - Kiseljak-Vassiliades, Katja
AU - Bancos, Irina
AU - Hamrahian, Amir
AU - Habra, Mouhammed Amir
AU - Vaidya, Anand
AU - Levine, Alice C.
AU - Else, Tobias
N1 - Publisher Copyright:
Copyright © 2020 AACE.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Objective: The aim of this Disease State Clinical Review is to provide a practical approach to patients with newly diagnosed adrenocortical carcinoma, as well as to follow-up and management of patients with persistent or recurrent disease. Methods: This is a case-based clinical review. The provided recommendations are based on evidence availAâble from randomized prospective clinical studies, cohort studies, cross-sectional and case-based studies, and expert opinions. Results: Adrenocortical carcinoma is a rare maligÂnancy, often with poor outcomes. For any patient with an adrenal mass suspicious for adrenocortical carcinoma, the approach should include prompt evaluation with detailed history and physical exam, imaging, and biochemical adreÂnal hormone assessment. In addition to adrenal-focused imaging, patients should be evaluated with chest-abdomen-pelvis cross-sectional imaging to define the initial therapy plan. Patients with potentially resectable disease limited to the adrenal gland should undergo en bloc open surgery by an expert surgeon. For patients presenting with advanced or recurrent disease, a multidisciplinary approach considAêring curative repeat surgery, local control with surgery, radiation therapy or radiofrequency ablation, or systemic therapy with mitotane and/or cytotoxic chemotherapy is recommended. Conclusion: As most health care providers will rareÂly encounter a patient with adrenocortical carcinoma, we recommend that patients with suspected adrenocortical carcinoma be evaluated by an expert multidisciplinary team which includes clinicians with expertise in adrenal tumors, including endocrinologists, oncologists, surgeons, radiation oncologists, pathologists, geneticists, and radiolAôgists. We recommend that patients in remote locations be followed by the local health care provider in collaboration with a multidisciplinary team at an expert adrenal tumor program..
AB - Objective: The aim of this Disease State Clinical Review is to provide a practical approach to patients with newly diagnosed adrenocortical carcinoma, as well as to follow-up and management of patients with persistent or recurrent disease. Methods: This is a case-based clinical review. The provided recommendations are based on evidence availAâble from randomized prospective clinical studies, cohort studies, cross-sectional and case-based studies, and expert opinions. Results: Adrenocortical carcinoma is a rare maligÂnancy, often with poor outcomes. For any patient with an adrenal mass suspicious for adrenocortical carcinoma, the approach should include prompt evaluation with detailed history and physical exam, imaging, and biochemical adreÂnal hormone assessment. In addition to adrenal-focused imaging, patients should be evaluated with chest-abdomen-pelvis cross-sectional imaging to define the initial therapy plan. Patients with potentially resectable disease limited to the adrenal gland should undergo en bloc open surgery by an expert surgeon. For patients presenting with advanced or recurrent disease, a multidisciplinary approach considAêring curative repeat surgery, local control with surgery, radiation therapy or radiofrequency ablation, or systemic therapy with mitotane and/or cytotoxic chemotherapy is recommended. Conclusion: As most health care providers will rareÂly encounter a patient with adrenocortical carcinoma, we recommend that patients with suspected adrenocortical carcinoma be evaluated by an expert multidisciplinary team which includes clinicians with expertise in adrenal tumors, including endocrinologists, oncologists, surgeons, radiation oncologists, pathologists, geneticists, and radiolAôgists. We recommend that patients in remote locations be followed by the local health care provider in collaboration with a multidisciplinary team at an expert adrenal tumor program..
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U2 - 10.4158/DSCR-2020-0567
DO - 10.4158/DSCR-2020-0567
M3 - Article
C2 - 33875173
AN - SCOPUS:85097291066
SN - 1530-891X
VL - 26
SP - 1366
EP - 1383
JO - Endocrine Practice
JF - Endocrine Practice
IS - 11
ER -