open access

Vol 88, No 10 (2017)
Clinical vignette
Published online: 2017-10-31
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Use of a levonorgestrel-releasing intrauterine device for menorrhagia treatment during adjuvant therapy of adrenocortical carcinoma with mitotane

Piotr Robert Szkodziak1, Piotr Czuczwar1, Sławomir Woźniak1, Filip Szkodziak2, Tomasz Paszkowski1
DOI: 10.5603/GP.a2017.0104
·
Pubmed: 29192420
·
Ginekol Pol 2017;88(10):576-577.
Affiliations
  1. 3rd Chair and Department of Gynecology Medical University in Lublin, Jaczewskiego 8, 20-954 Lublin, Poland
  2. Student research circle at the 3rd Chair and Department of Gynecology, Medical Univeristy in Lublin, Poland, Jaczewskiego 8, 20-954 Lublin, Poland

open access

Vol 88, No 10 (2017)
CLINICAL VIGNETTES
Published online: 2017-10-31

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.

Get Citation

Keywords

menorrhagia, levonorgestrel-releasing intrauterine device, LNG-IUD, mitotane, adjuvant therapy, adrenocortical carcinoma

About this article
Title

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

Journal

Ginekologia Polska

Issue

Vol 88, No 10 (2017)

Article type

Clinical vignette

Pages

576-577

Published online

2017-10-31

DOI

10.5603/GP.a2017.0104

Pubmed

29192420

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

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