Use of a levonorgestrel-releasing intrauterine device for menorrhagia treatment during adjuvant therapy of adrenocortical carcinoma with mitotane.

Abstract

Adrenocortical carcinoma is a rare tumour with high malignancy and poor prognosis. This tumour is rarely diagnosed in the reproductive age. Complete surgical resection is the only curative treatment for adrenal cancer in all stages. After surgery adjuvant chemotherapy is required. Mitotane is the most important drug in adrenal cancer chemotherapy. Mitotane's mode of action is not entirely explained. Animal studies have shown that the substance exerts a direct cytotoxic effect on the cells of the adrenal cortex. This activity is selective, progressive and affects only the zona reticularis and fasciculata of the adrenal cortex. Mitotane inhibits cortisol synthesis by disrupting the chain of cholesterol. It has been suggested, that mitotane also affects the peripheral metabolism of steroids, especially of transcortin (CBG). This results in an increase of CBG blood concentration and a reduction of the amount of free hormones.

• Authors: Piotr Robert Szkodziak, Piotr Czuczwar, Sławomir Woźniak, Filip Szkodziak, Tomasz Paszkowski
• Journal: Ginekologia polska (Ginekol Pol) Vol. 88 Issue 10 Pg. 576-577 ( 2017) ISSN: 0017-0011 [Print] Poland
• PMID: 29192420 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents, Hormonal
• Levonorgestrel
• Mitotane

Topics

• Adrenal Cortex Neoplasms (drug therapy, surgery)
• Adrenocortical Carcinoma (drug therapy, surgery)
• Adult
• Antineoplastic Agents, Hormonal (administration & dosage, therapeutic use)
• Chemotherapy, Adjuvant
• Diagnosis, Differential
• Female
• Humans
• Intrauterine Devices, Medicated
• Levonorgestrel (administration & dosage, therapeutic use)
• Menorrhagia (diagnosis, diagnostic imaging, drug therapy)
• Mitotane (administration & dosage, therapeutic use)