Complete response of metastasized adrenal cortical carcinoma with o,p'-ddd.Case report and literature review

Abstract
This study concerns the history of a male patient with hormone‐producing adrenal cortical carcinoma. Six months after resection of the primary tumor, lymph node metastases were detected and treatment with o,p'‐DDD[1,1 dichloro‐2‐(o‐chlorophenyl)‐2‐(p‐chlorophenyl)ethane] (Lysodren/mitotane) was started. After 2 years, a complete histologically proven response was confirmed at laparotomy and is still sustained 2 years after the discontinuation of treatment. As a consequence of insufficient steroid replacement the patient suffered bouts of adrenal insufficiency. After 1 year of treatment, the measurement of the plasma levels of o,p'‐DDD showed an accumulation of the drug. At that time, progressive major central nervous system toxicity occurred, which proved to be reversible on discontinuation of the treatment. Cancer 53:26‐29, 1984.