Embolization in an adrenocortical carcinoma as palliative therapy

Background: With an annual incidence of 0.2% of new cases per 100,000 inhab itants, adrenocortical carcinoma is rare. In advanced tumor only palliative treatment modalities are practicable. Because of scarcity of the tumor, st andard treatment has not been defined. The decision on therapy frequently d epends on the individual situation. Tumor embolization and chemotherapy are amongst the possible options. Patient and Methods: We report on a case of a 32-year-old female patient with a large-volume hormonally active adrenoco rtical carcinoma and hematogenous liver metastases. This carcinoma was conf irmed histologically by means of liver biopsy. Owing to the large tumor ext ent and metastatic spreading and also in view of the poor general condition of the patient, curative surgical therapy was not possible. For this reaso n, a local approach was chosen primarily with transarterial tumor embolizat ion at the capillary level. Systemic chemotherapy was given afterwards. Res ults: Improvement of the patient's general condition, especially the pronou nced pain symptoms, could be achieved for a short time by the embolization: both, the patient's clinical condition and the laboratory test parameters improved. However, a rapid tumor progression occured under chemotherapy, wh ich was started after embolization. Conclusion: In advanced adrenocortical carcinoma, tumor embolization can lead to a stabilization of the disease an d improvement of the symptoms as appraised by palliative criteria in some p atients.