Pregnancy in patients with adrenocortical carcinoma: a case-based discussion

• Published in: Reviews in endocrine & metabolic disorders 2023-02, Vol.24 (1), p.85-96
• Main Authors: Puglisi, Soraya, Basile, Vittoria, Sperone, Paola, Terzolo, Massimo
• Format: Article
• Language: English
• Subjects: Abdomen; Adrenal Cortex Neoplasms - diagnosis; Adrenal Cortex Neoplasms - pathology; Adrenal Cortex Neoplasms - therapy; Adrenal glands; Adrenocortical Carcinoma - diagnosis; Adrenocortical Carcinoma - pathology; Adrenocortical Carcinoma - therapy; Age; Cancer; Carcinoma; Care and treatment; Collaboration; Diabetes; Endocrinology; Female; Fertility; Fetuses; Gynecology; Hormones; Hospitals; Humans; Hypertension; Internal Medicine; Male; Medical prognosis; Medicine; Medicine & Public Health; Metabolic disorders; Metastasis; Mitotane; Neuroendocrine tumors; Patients; Pregnancy; Pregnant women; Retrospective Studies; Steroids; Tumors; Ultrasonic imaging; Womens health
• ISSN: 1389-9155; 1573-2606
• DOI: 10.1007/s11154-022-09769-y

Although adrenocortical carcinoma (ACC) during pregnancy is rare, a retrospective review of a case series at our hospital revealed that almost one third of our patients were women in childbearing age. Given that the age of maternity is increasing, dealing with a tumor diagnosis during pregnancy and the need for fertility planning in cancer survivors is likely to become more frequent. We thus carried out a case-based discussion regarding: i) diagnosing and treating an ACC during pregnancy; ii) patients conceiving while on mitotane; iii) ACC survivors with a maternal desire. In each of these cases, it is important to provide patients with sufficient information, to offer medical advice and psychological support, to personalize treatments in accordance with the wishes of the patient and her relatives, and to collaborate with other specialists since a multidisciplinary expert team is required to manage each case individually.