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Angelo Paci, Ségolène Hescot, Atmane Seck, Christel Jublanc, Lionel Mercier, Delphine Vezzosi, Delphine Drui, Marcus Quinkler, Martin Fassnacht, Eric Bruckert, Marc Lombès, Sophie Leboulleux, Sophie Broutin and Eric Baudin

Background Monitoring plasma mitotane levels is recommended in the follow-up of patients with unresectable adrenocortical carcinoma (ACC) to look for a therapeutic window of 14–20mg/L to optimize benefit over risk and avoid toxicities ( 1

Open access

Philip D Oddie, Benjamin B Albert, Paul L Hofman, Craig Jefferies, Stephen Laughton and Philippa J Carter

. The primary treatment modality is surgery, but adjuvant chemotherapy is important ( 1 ), especially where there is evidence of residual disease or adverse histology. Mitotane is an adrenal-selective chemotherapeutic agent derived from the insecticide

Open access

S Hussain, E Panteliou, D M Berney, R Carpenter, M Matson, A Sahdev, M Bell, E O'Sullivan and W M Drake

Eplerenone 50 mg daily. In view of the histological findings, he commenced mitotane therapy, aiming for a target serum level of 14–20 mg/l. A 3-month follow-up CT scan was suspicious for local metastases in the adrenal bed, without evidence of distant

Open access

Impana Shetty, Sarah Fuller, Margarita Raygada, Maria J Merino, B J Thomas, Brigitte C Widemann, Karlyne M Reilly, Karel Pacak and Jaydira Del Rivero

important as certain features, such as the mitotic rate, have been shown to predict outcomes and may be used to further guide treatment ( 9 ). Mitotane can be given as a type of adjuvant therapy after surgical resection as treatment for patients with

Open access

Ravi Kumar Menon, Francesco Ferrau, Tom R Kurzawinski, Gill Rumsby, Alexander Freeman, Zahir Amin, Márta Korbonits and Teng-Teng L L Chung

months following the surgery did not show any increased uptake in the tumour bed or elsewhere. As this was classified as European Network for the Study of Adrenal Tumours (ENSAT) stage 2 ACC, the patient was initiated on adjuvant mitotane 500 mg once

Open access

Shinobu Takayasu, Shingo Murasawa, Satoshi Yamagata, Kazunori Kageyama, Takeshi Nigawara, Yutaka Watanuki, Daisuke Kimura, Takao Tsushima, Yoshiyuki Sakamoto, Kenichi Hakamada, Ken Terui and Makoto Daimon

. The patient was diagnosed with ectopic ACTH syndrome after endocrinological analyses. She was administered steroidogenesis inhibitors, metyrapone and mitotane, to suppress cortisol secretion. Serum cortisol and UFC levels fell to around 20 μg/dL and

Open access

Ayanthi A Wijewardene, Sarah J Glastras, Diana L Learoyd, Bruce G Robinson and Venessa H M Tsang

to proceed with adrenalectomy, and so, the operation was abandoned. In a further attempt to control the Cushing’s syndrome, ketoconazole was replaced with mitotane. Mitotane was titrated from a starting dose of 500 mg twice daily and increased to 1000

Open access

Katia Regina Marchetti, Maria Adelaide Albergaria Pereira, Arnaldo Lichtenstein and Edison Ferreira Paiva

included cisplatin, etoposide, doxorubicin, and mitotane, whereas the second cycle involved cisplatin; no response to either regimen was observed. After 3 months, the patient’s condition worsened and progressed to death. Outcome and follow-up No

Open access

Satoru Sakihara, Kazunori Kageyama, Satoshi Yamagata, Ken Terui, Makoto Daimon and Toshihiro Suda

-line treatment for EAS. In cases where the source of ACTH secretion is unknown, inhibitors of steroidogenesis, such as metyrapone, mitotane, ketoconazole, and etomidate, are mostly used to suppress cortisol secretion (3) . We present the case of EAS, for which

Open access

Skand Shekhar, Sriram Gubbi, Georgios Z Papadakis, Naris Nilubol and Fady Hannah-Shmouni

(ENSAT) criteria), adjuvant mitotane therapy was shown to significantly improve recurrence-free survival ( 9 , 11 ). For reccurent or metastastic ACCs (stage IV, ENSAT criteria), surgical resection can be considered only if two tumoral organs are present