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Adrenocortical Carcinomas (ACC) are ultra-rare tumors that have a high incidence of recurrence despite complete resection. The treatment for an ACC and its recurrence involves a multi-modality approach which includes surgery, chemotherapy and radiotherapy (RT). The role of radiotherapy for the management of this rare disease can be as definitive, neo-adjuvant or adjuvant treatment.
This is a case of a 27 year old female who presented with left lower quadrant pain, 27 months after adrenalectomy for Adrenocortical Carcinoma Left Stage II. She as Chronic Kidney Disease Stage III and ectopic left kidney as co-morbids. The recurrence was non-functional and was deemed inoperable by the Surgeon.
She was referred to Radiation Oncology Service and underwent 30 sessions of radiotherapy (RT) with concurrent weekly low dose Cisplatin, followed by 6 cycles of Doxorubicin and 3 cycles of high dose Cisplatin. Intensity Modulated Radiation Therapy (IMRT), was directed to recurrent tumors while minimizing dose exposure to the organs at risk. Follow up imaging showed a significant decrease in the size of the recurrent tumors.