The History of Adrenocortical Carcinoma Treatment – A Medical Perspective

  • David E. SchteingartEmail author


Knowledge of the genetic and molecular alterations in adrenocortical carcinoma (ACC) has advanced in the past two decades, as a result of newer laboratory methodology to study mechanisms of oncogenesis and tumor pathophysiology. In contrast, limited progress has been made in our ability to treat and prolong survival in patients with advanced disease. Over the past five decades, a number of reports have summarized the experience of individual medical institutions with ACC; and collectively, based on several thousand cases, there is relative consensus on the epidemiology of ACC, its clinical presentation, criteria for pathological diagnosis, and tumor response to standard cytotoxic chemotherapy. Unfortunately, survival of patients with advanced disease remains poor (Fig. 1.1), and targeted therapies based on new knowledge of the biology of these tumors are only in clinical trial phase. This introduction will attempt to highlight the early experience with mitotane that forms the basis of our current approach to the management of patients with ACC.


Congenital Adrenal Hyperplasia Adrenocortical Carcinoma Clinical Trial Phase Relative Consensus Adrenocortical Hyperplasia 
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  1. 1.
    Brennan MF (1987) Adrenocortical carcinoma. CA Cancer J Clin 37:348–365CrossRefPubMedGoogle Scholar
  2. 2.
    Soffer LJ et al (1961) The human adrenal gland. Lea & Febiger, Philadelphia, PAGoogle Scholar
  3. 3.
    Cecil HF (1933) Hypertension, obesity, virilism and pseudohermaphroditism as caused by suprarenal tumors. J.A.M.A 100:463Google Scholar
  4. 4.
    Eisenstein AB (1967) The adrenal cortex. Little, Brown and Company, Boston, MAGoogle Scholar
  5. 5.
    Schteingart DE et al (1982) The treatment of adrenal carcinoma. Arch Surg 117:1142–1146PubMedGoogle Scholar
  6. 6.
    Thompson NW (1983) Adrenocortical carcinoma. In: Thompson NW, Vinik AI (eds) Endocrine surgery update. Grune and Stratton, New York, pp 119–128Google Scholar
  7. 7.
    Luton JP et al (1990) Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy. N Engl J Med 322:1195–1201CrossRefPubMedGoogle Scholar
  8. 8.
    Hogan TF et al (1978) o,p'-DDD (mitotane) therapy of adrenal cortical carcinoma: observations on drug dosage, toxicity and steroid replacement. Cancer 42:2177–2181CrossRefPubMedGoogle Scholar
  9. 9.
    Bilimoria KY et al (2008) Adrenocortical carcinoma in the United States. Treatment utilization and prognostic factors. Cancer 113(11):3130–3136CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Endocrine Oncology Program, Comprehensive Cancer CenterUniversity of MichiganAnn ArborUSA

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