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Use of a levonorgestrel-releasing intrauterine device for menorrhagia treatment during adjuvant therapy of adrenocortical carcinoma with mitotane
Affiliations- 3rd Chair and Department of Gynecology Medical University in Lublin, Jaczewskiego 8, 20-954 Lublin, Poland
- Student research circle at the 3rd Chair and Department of Gynecology, Medical Univeristy in Lublin, Poland, Jaczewskiego 8, 20-954 Lublin, Poland
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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.
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.
Keywords
menorrhagia, levonorgestrel-releasing intrauterine device, LNG-IUD, mitotane, adjuvant therapy, adrenocortical carcinoma
About this articleTitle
Use of a levonorgestrel-releasing intrauterine device for menorrhagia treatment during adjuvant therapy of adrenocortical carcinoma with mitotane
Journal
Issue
Article type
Clinical vignette
Pages
576-577
Published online
2017-10-31
Page views
1120
Article views/downloads
1054
DOI
10.5603/GP.a2017.0104
Pubmed
Bibliographic record
Ginekol Pol 2017;88(10):576-577.
Keywords
menorrhagia
levonorgestrel-releasing intrauterine device
LNG-IUD
mitotane
adjuvant therapy
adrenocortical carcinoma
Authors
Piotr Robert Szkodziak
Piotr Czuczwar
Sławomir Woźniak
Filip Szkodziak
Tomasz Paszkowski
