Adrenocortical carcinoma mimicking lung cancer and responding to vinorelbine/carboplatin and pemetrexed/carboplatin

摘要: Adrenocortical carcinoma is an aggressive cancer, with incidence of 0.5–2 per million. We present a case adrenocortical all the clinical and partly immunohistochemical features disseminated undifferentiated lung ‘accidentally’ treated as such. Four cycles carboplatin–vinorelbine conferred partial response in adrenal, disappearance 2 cm subcutaneous iliac nodule that had appeared suddenly before first course. Owing to progression, four carboplatin–pemetrexed were administered inducing then stable disease for additional 12 months. As fluoro-d-glucose (FDG)-positron emission tomography (PET) only showed activity laparoscopic adrenalectomy was performed. Three months later FDG-PET revealed unresponsive carboplatin–pemetrexed, removed by wedge resection. Finally, re-evaluation tertiary centre confirmed Ki67—50% adrenal lung. The patient alive tumour free almost 3.5 years after retrospective diagnosis metastatic cancer.