mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2015-1-4-20mvjr-184Research ArticleСтатьиПРОЕКТ РОССИЙСКИХ КЛИНИЧЕСКИХ РЕКОМЕНДАЦИЙ ПО ДИАГНОСТИКЕ И ЛЕЧЕНИЮ АДРЕНОКОРТИКАЛЬНОГО РАКАDRAFT OF RUSSIAN GUIDELINES OF DIAGNOSIS AND TREATMENT OF ADRENAL CORTICAL CANCERМельниченкоГ. А.MelnichenkoG. A.

академик РАМН

academician of Russian Academy of Medical Sciences

СтилидиИ. С.StilidiI. S.

член-корр. РАМН

associate of Russian Academy of Medical Sciences

ГорбуноваВ. А... .

проф., доктор мед. наук

АлексеевБ. Я.AlexeevB. Ya.

проф., доктор мед. наук

MD, prof.

БельцевичД. Г.BeltsevichD. G.

доктор мед. наук

MD

РайхманА. О.RaykhmanA. O.КузнецовН. С.KuznetsovN. S.

проф., доктор мед. наук 

prof.

ЖуковН. В.ZhukovN. V.

канд. мед. наук

Cand. Med. Sci.

БохянВ. Ю.BokhyanV. Yu.

доктор мед. наук

MD

ФГБУ “Эндокринологический научный центр” МЗ РФРоссияEndocrinol Res CtrRussian FederationФГБУ “Российский онкологический научный центр им. Н.Н. Блохина” РАМНРоссияBlokhin RCRC RAMS SR Inst Pediat Oncol & HematolRussian FederationФГБУ “Российский онкологический научный центр им. Н.Н. Блохина” РАМНRussian FederationФГБУ “Московский научно-исследовательский онкологический институт им. П.А.Герцена” МЗ РФРоссияHertsen Federal Medical Research Centre of the Ministry of Health of the Russian FederationRussian FederationГБОУ ВПО “Первый Московский Государственный Университет им И.М. Сеченова” МЗ РФРоссияI.M. Sechenov First Moscow State Medical UniversityRussian FederationФГБУ “Московский научно-исследовательский онкологический институт им. П.А.Герцена” МЗ РФ, ФГБУ ФНКЦ Детской гематологии, онкологии и иммунологии им. Д.Рогачева МЗ РФРоссияHertsen Federal Medical Research Centre of the Ministry of Health of the Russian Federation; he in the FSCC PHOI n.a. Dmitry RogachevRussian Federation20153003201501420Copyright © Мельниченко Г.А., Стилиди И.С., Горбунова В.А., Алексеев Б.Я., Бельцевич Д.Г., Райхман А.О., Кузнецов Н.С., Жуков Н.В., Бохян В.Ю., 20152015Мельниченко Г.А., Стилиди И.С., Горбунова В.А., Алексеев Б.Я., Бельцевич Д.Г., Райхман А.О., Кузнецов Н.С., Жуков Н.В., Бохян В.Ю.Melnichenko G.A., Stilidi I.S., . ...., Alexeev B.Y., Beltsevich D.G., Raykhman A.O., Kuznetsov N.S., Zhukov N.V., Bokhyan V.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/184

Определение гормональной активности и злокачественного потенциала – актуальнейший вопрос диагностики и выбора лечебной тактики при опухолях надпочечников. Адренокортикальный рак (АКР) – достаточно редкое заболевание, которое характеризуется плохими прогностическими показателями. Встречаемость АКР - 0,5–2 случая на миллион населения, в структуре инциденталом надпочечников не более чем в 2–4% наблюдений. Для широкого обсуждения предлагается проект клинических рекомендаций по диагностике и лечению АКР, предназначенный для онкологов, хирургов, эндокринологов, специалистов по лучевой диагностике, патоморфологов и др.

Statement of hormonal activity and potential malignancy are the most important issues of diagnosis and selection of appropriate treatment way for patients with adrenal tumors. Adrenal cortical carcinoma (ACC) is rare disease with poor prognosis. Incidience of ACC is about 0.5–2per million, and no more then 2–4% among adrenal tumors. Th is draft of guidelines of diagnosis and treatment of ACC is off ered to common discussion among wide round of specialists.

опухоли надпочечникаадренокортикальный ракрак коры надпочечникафеохромоцитомапараганглиомагиперкортицизммитотанadrenal tumorsadrenal cortical cancerpheochromocytomaparagangliomahypercortysolismmitotaneReferencesBerrutiA, BaudinE, GelderblomHet al. Adrenal cancer: ESMO (European Society for Medical Oncology) Clinical Practice Guidelines for diagnosis, treatment and follow-up on behalf of the ESMO Guidelines Working Group. Annals of Oncology.BerrutiA, BaudinE, GelderblomHet al. Adrenal cancer: ESMO (European Society for Medical Oncology) Clinical Practice Guidelines for diagnosis, treatment and follow-up on behalf of the ESMO Guidelines Working Group. Annals of Oncology.;23:131-138.;23:131-138.NCCN Clinical Practice Guidelines in Oncology, Neuroendocrine tumor, Version 1.2014.NCCN Clinical Practice Guidelines in Oncology, Neuroendocrine tumor, Version 1.2014.Schteingart DE, Doherty GM, Gauger PG et al. Management of patients with adrenal cancer: recommendations of an international consensus conference. Endocr Relat Cancer. 2005;12:667.Schteingart DE, Doherty GM, Gauger PG et al. Management of patients with adrenal cancer: recommendations of an international consensus conference. Endocr Relat Cancer. 2005;12:667.Langer P, Cupisti K, Bartsch DK et al. Adrenal involvement in multiple endocrine neoplasia type 1.World J Surg.2002;26:891- 896.Langer P, Cupisti K, Bartsch DK et al. Adrenal involvement in multiple endocrine neoplasia type 1.World J Surg.2002;26:891- 896.Gicquel C, Le Bouc Y. Molecular markers for malignancy in adrenocortical tumors. Horm Res.1997;47:269-272.Gicquel C, Le Bouc Y. Molecular markers for malignancy in adrenocortical tumors. Horm Res.1997;47:269-272.БельцевичДГ, КузнецовНС, СолдатоваТВ, ВанушкоВЭ. Инциденталоманадпочечников.Эндокриннаяхирургия. 2009.№1.БельцевичДГ, КузнецовНС, СолдатоваТВ, ВанушкоВЭ. Инциденталоманадпочечников.Эндокриннаяхирургия. 2009.№1.Bovio S, Cataldi A, Reimondo G, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest. 2006;29:298-302.Bovio S, Cataldi A, Reimondo G, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest. 2006;29:298-302.Young W.F.,Jr. Th e Incidentally Discovered Adrenal Mass. N Engl J Med. 2007;356:601-10.Young W.F.,Jr. Th e Incidentally Discovered Adrenal Mass. N Engl J Med. 2007;356:601-10.Cawood T J, Hunt P J, O’Shea D, Cole D, Soule S. Recommended evaluation of adrenal incidentalomas is costly, has high falsepositive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant; time for a rethink? Literature review. Eur J Endocrinol. 2009;161:513-527.Cawood T J, Hunt P J, O’Shea D, Cole D, Soule S. Recommended evaluation of adrenal incidentalomas is costly, has high falsepositive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant; time for a rethink? Literature review. Eur J Endocrinol. 2009;161:513-527.Libe R, Dall’Asta C, Barbetta L et al. Long-term follow-up study of patients with adrenal incidentalomas. Eur J Endocrinol. 2002;147:489–494.Libe R, Dall’Asta C, Barbetta L et al. Long-term follow-up study of patients with adrenal incidentalomas. Eur J Endocrinol. 2002;147:489–494.Terzolo M, Reimondo G, Bovio S, Angeli ASubclinical Cushing’s syndrome. Pituitary. 2004;7:217-223.Terzolo M, Reimondo G, Bovio S, Angeli ASubclinical Cushing’s syndrome. Pituitary. 2004;7:217-223.Kirkby-Bott J, Brunaud L, Mathonet M, Hamoir E, Kraimps JL, Tresallet C, Amar L, Rault A, Henry JF, Carnaille B. Ectopic hormone-secreting pheochromocytoma: a francophone observational study. World J Surg. 2012;36(6):1382-1388.Kirkby-Bott J, Brunaud L, Mathonet M, Hamoir E, Kraimps JL, Tresallet C, Amar L, Rault A, Henry JF, Carnaille B. Ectopic hormone-secreting pheochromocytoma: a francophone observational study. World J Surg. 2012;36(6):1382-1388.Li XG, Zhang DX, Li X, Cui XG, Xu DF, Li Y, Gao Y, Yin L, Ren JZ Adrenocorticotropic hormone-producing pheochromocytoma: a case report and review of the literature. Chin Med J (Engl). 2012;125(6):1193-1196.Li XG, Zhang DX, Li X, Cui XG, Xu DF, Li Y, Gao Y, Yin L, Ren JZ Adrenocorticotropic hormone-producing pheochromocytoma: a case report and review of the literature. Chin Med J (Engl). 2012;125(6):1193-1196.Cohade C, Broussaud S, Louiset E, Bennet A, Huyghe E, Caron P. Ectopic Cushing’s syndrome due to a pheochromocytoma: a new case in the post-partum and review of literature.Gynecol Endocrinol. 2009;25(9):624-627.Cohade C, Broussaud S, Louiset E, Bennet A, Huyghe E, Caron P. Ectopic Cushing’s syndrome due to a pheochromocytoma: a new case in the post-partum and review of literature.Gynecol Endocrinol. 2009;25(9):624-627.Gardet V et al.Lessons from an unpleasant surprise: a biochemical strategy for the diagnosis of pheochromocytoma. J Hypertens.2001;19:1029-1035.Gardet V et al.Lessons from an unpleasant surprise: a biochemical strategy for the diagnosis of pheochromocytoma. J Hypertens.2001;19:1029-1035.NiemanLK, BillerBMK, FindlingJWet al. Th e diagnosis of Cushing’s syndrome:an endocrine society clinical practice guideline Journal of Clin Endoc & Met. 2008;93(5):1526-1540.NiemanLK, BillerBMK, FindlingJWet al. Th e diagnosis of Cushing’s syndrome:an endocrine society clinical practice guideline Journal of Clin Endoc & Met. 2008;93(5):1526-1540.Newell-Price J, Trainer P, Besser M, Grossman A Th e diagnosis and diff erential diagnosis of Cushing’s syndrome and pseudo-Cushing’s states. Endocr Rev 1998;19:647-672.Newell-Price J, Trainer P, Besser M, Grossman A Th e diagnosis and diff erential diagnosis of Cushing’s syndrome and pseudo-Cushing’s states. Endocr Rev 1998;19:647-672.Pecori Giraldi F, Ambrogio AG, De Martin Met al. Specifi city of fi rst-line tests for the diagnosis of Cushing’s syndrome: assessment in a large series. J Clin Endocrinol Metab.2007;92:4123-4129.Pecori Giraldi F, Ambrogio AG, De Martin Met al. Specifi city of fi rst-line tests for the diagnosis of Cushing’s syndrome: assessment in a large series. J Clin Endocrinol Metab.2007;92:4123-4129.Tsagarakis S, Vassiliadi D, Th alassinos N. Endogenous subclinical hypercortisolism: diagnostic uncertainties and clinical implications. J Endocrinol Invest.2006;29:471-482.Tsagarakis S, Vassiliadi D, Th alassinos N. Endogenous subclinical hypercortisolism: diagnostic uncertainties and clinical implications. J Endocrinol Invest.2006;29:471-482.Mitchell IC, Auchus RJ, Juneja Ket al. “Subclinical Cushing’s syndrome” is not subclinical: improvement aft er adrenalectomy in 9 patients. Surgery 2007;142:900-905.Mitchell IC, Auchus RJ, Juneja Ket al. “Subclinical Cushing’s syndrome” is not subclinical: improvement aft er adrenalectomy in 9 patients. Surgery 2007;142:900-905.Mitchell IC, Auchus RJ, Juneja K et al. “Subclinical Cushing’s syndrome” is not subclinical: improvement aft er adrenalectomy in 9 patients. Surgery 2007;142:900-905.Mitchell IC, Auchus RJ, Juneja K et al. “Subclinical Cushing’s syndrome” is not subclinical: improvement aft er adrenalectomy in 9 patients. Surgery 2007;142:900-905.Barzon L, Fallo F, Sonino N, Boscaro M. Development of overt Cushing’s syndrome in patients with adrenal incidentaloma. Eur J Endocrinol. 2002;146:61-66.Barzon L, Fallo F, Sonino N, Boscaro M. Development of overt Cushing’s syndrome in patients with adrenal incidentaloma. Eur J Endocrinol. 2002;146:61-66.Reincke M Subclinical Cushing’s syndrome. Endocrinol Metab Clin North Am. 2000;29:43-56.Reincke M Subclinical Cushing’s syndrome. Endocrinol Metab Clin North Am. 2000;29:43-56.Pacak K Preoperative management of the pheochromocytoma patient. J Clin Endocrinol Metab 2007;92:4069-4079.Pacak K Preoperative management of the pheochromocytoma patient. J Clin Endocrinol Metab 2007;92:4069-4079.Williams DT, Dann S, Wheeler MH. Phaeochromocytoma – views on current management. Eur J Surg Oncol.2003;29:483-490.Williams DT, Dann S, Wheeler MH. Phaeochromocytoma – views on current management. Eur J Surg Oncol.2003;29:483-490.Kinney MA et al. Perioperative management of pheochromocytoma. J Cardiothorac Vasc Anesth.2002;16:359-369.Kinney MA et al. Perioperative management of pheochromocytoma. J Cardiothorac Vasc Anesth.2002;16:359-369.Pacak K et al.Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann InternPacak K et al.Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann InternMed.2001;134:315-329.Med.2001;134:315-329.Дедов ИИ, Бельцевич ДГ, Кузнецов НС, Мельниченко ГА. Феохромоцитома. Москва, РФ: Практ. медицина; 2005;47-70.Дедов ИИ, Бельцевич ДГ, Кузнецов НС, Мельниченко ГА. Феохромоцитома. Москва, РФ: Практ. медицина; 2005;47-70.An Endocrine Society Clinical Practice Guidelines. Case Detection, Diagnosis, and Treatment of Patients with Primary Aldosteronism. J Clin Endocrinol Metab. 2008;93(9):3266-3281.An Endocrine Society Clinical Practice Guidelines. Case Detection, Diagnosis, and Treatment of Patients with Primary Aldosteronism. J Clin Endocrinol Metab. 2008;93(9):3266-3281.Трошина ЕА, Бельцевич ДГ, Молашенко НВ. Диагностика и дифференциальная диагностика первичного гиперальдостеронизма. Клиническаямедицина. 2009;5:15-20.Трошина ЕА, Бельцевич ДГ, Молашенко НВ. Диагностика и дифференциальная диагностика первичного гиперальдостеронизма. Клиническаямедицина. 2009;5:15-20.Mantero F, Terzolo M, Arnaldi G, et al. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. J Clin Endocrinol Metab.2000;85(2):637-644.Mantero F, Terzolo M, Arnaldi G, et al. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. J Clin Endocrinol Metab.2000;85(2):637-644.Angeli A, Osella G, Ali A, Terzolo M. Adrenal incidentaloma: an overview of clinical and epidemiological data from the National Italian Study Group. Horm Res. 1997;47:279-283.Angeli A, Osella G, Ali A, Terzolo M. Adrenal incidentaloma: an overview of clinical and epidemiological data from the National Italian Study Group. Horm Res. 1997;47:279-283.Metser U,MillerE, LermanH et al.18F-FDG PET/CT in the Evaluation of Adrenal Masses. J Nucl Med. 2006;47(1):32-37.Metser U,MillerE, LermanH et al.18F-FDG PET/CT in the Evaluation of Adrenal Masses. J Nucl Med. 2006;47(1):32-37.M. Blake, P. Prakash, C.Cronin. PET/CT for Adrenal Assessment Am J Roentgenology. 2010;195(2):195.M. Blake, P. Prakash, C.Cronin. PET/CT for Adrenal Assessment Am J Roentgenology. 2010;195(2):195.Mackie GC, Shulkin BL, Ribeiro RC, et al. Use of [18F] fl uorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma. J Clin Endocrinol Metab. 2006;91:2665.Mackie GC, Shulkin BL, Ribeiro RC, et al. Use of [18F] fl uorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma. J Clin Endocrinol Metab. 2006;91:2665.Leboulleux S, Dromain C, Bonniaud G et al. Diagnostic and prognostic value of 18-fl uorodeoxyglucose positron emission tomography in adrenocortical carcinoma: a prospective comparison with computed tomography. J Clin EndocrinolLeboulleux S, Dromain C, Bonniaud G et al. Diagnostic and prognostic value of 18-fl uorodeoxyglucose positron emission tomography in adrenocortical carcinoma: a prospective comparison with computed tomography. J Clin EndocrinolMetab. 2006;91:920.Metab. 2006;91:920.Deandreis D, Leboulleux S, Caramella C, et al. FDG PET in the management of patients with adrenal masses and adrenocortical carcinoma. Horm Cancer. 2011;2:354.Deandreis D, Leboulleux S, Caramella C, et al. FDG PET in the management of patients with adrenal masses and adrenocortical carcinoma. Horm Cancer. 2011;2:354.Harisinghani MG, Maher MM, Hahn PF et al. Predictive value of benign percutaneous adrenal biopsies in oncology patients. Clin Radiol. 2002;57:898-901.Harisinghani MG, Maher MM, Hahn PF et al. Predictive value of benign percutaneous adrenal biopsies in oncology patients. Clin Radiol. 2002;57:898-901.Arellano RS, Harisinghani MG, Gervais DA et al Imageguided percutaneous biopsy of the adrenal gland: review of indications, technique, and complications. Curr Probl Diagn Radiol. 2003;32:3-10.Arellano RS, Harisinghani MG, Gervais DA et al Imageguided percutaneous biopsy of the adrenal gland: review of indications, technique, and complications. Curr Probl Diagn Radiol. 2003;32:3-10.Welch TJ, Sheedy PF II, Stephens DH et al. Percutaneous adrenal biopsy: review of a 10-year experience. Radiology. 1994;193:341-344.Welch TJ, Sheedy PF II, Stephens DH et al. Percutaneous adrenal biopsy: review of a 10-year experience. Radiology. 1994;193:341-344.Casola G, Nicolet V, van Sonnenberg E et al. Unsuspected pheochromocytoma: risk of blood-pressure alterations during percutaneous adrenal biopsy. Radiology. 1986;159:733-735.Casola G, Nicolet V, van Sonnenberg E et al. Unsuspected pheochromocytoma: risk of blood-pressure alterations during percutaneous adrenal biopsy. Radiology. 1986;159:733-735.McCorkell SJ, Niles NL. Fine-needle aspiration of catecholamineproducing adrenal masses: a possibly fatal mistake. Am J Roentgenol. 1985;145:113-114.McCorkell SJ, Niles NL. Fine-needle aspiration of catecholamineproducing adrenal masses: a possibly fatal mistake. Am J Roentgenol. 1985;145:113-114.Pacak K, Eisenhofer G, Ahlman H et al.Pheochromocytoma: recommendations for clinical practice from the First International Symposium. Nat Clin Pract Endocrinol Metab.2007;3:92-102.Pacak K, Eisenhofer G, Ahlman H et al.Pheochromocytoma: recommendations for clinical practice from the First International Symposium. Nat Clin Pract Endocrinol Metab.2007;3:92-102.SaegerW, FassnachtM, ChitaR. High Diagnostic Accuracy of Adrenal CoreBiopsy: Results of the German and Austrian Adrenal Network Multicenter Trial in 220 Consecutive Patients. Human pathology. 2003;34(2):180-186.SaegerW, FassnachtM, ChitaR. High Diagnostic Accuracy of Adrenal CoreBiopsy: Results of the German and Austrian Adrenal Network Multicenter Trial in 220 Consecutive Patients. Human pathology. 2003;34(2):180-186.Dackiw AP, Lee JE, Gagel RF, Evans DB. Adrenal cortical carcinoma. World J Surg.2001;25:914-926Dackiw AP, Lee JE, Gagel RF, Evans DB. Adrenal cortical carcinoma. World J Surg.2001;25:914-926Ng L, Libertino JM. Adrenocortical carcinoma: diagnosis, evaluation and treatment. J Urol.2003;169:5-11.Ng L, Libertino JM. Adrenocortical carcinoma: diagnosis, evaluation and treatment. J Urol.2003;169:5-11.Miller BS, Gauger PG, Hammer GD et al. Proposal for modifi cation of the ENSAT staging system for adrenocortical carcinoma using tumor grade. Langenbecks Arch Surg.2010;395:955.Miller BS, Gauger PG, Hammer GD et al. Proposal for modifi cation of the ENSAT staging system for adrenocortical carcinoma using tumor grade. Langenbecks Arch Surg.2010;395:955.Fassnacht M, Johanssen S, Quinkler M et al. Limited prognostic value of the 2004 International Union Against Cancer staging classifi cation for adrenocortical carcinoma: proposal for a Revised TNM Classifi cation. Cancer 2009;115:243.Fassnacht M, Johanssen S, Quinkler M et al. Limited prognostic value of the 2004 International Union Against Cancer staging classifi cation for adrenocortical carcinoma: proposal for a Revised TNM Classifi cation. Cancer 2009;115:243.Wangberg B, Khorram-Manesh A, Jansson S, et al. Th e longterm survival in adrenocortical carcinoma with active surgical management and use of monitored mitotane. Endocr Relat Cancer. 2010;17:265.Wangberg B, Khorram-Manesh A, Jansson S, et al. Th e longterm survival in adrenocortical carcinoma with active surgical management and use of monitored mitotane. Endocr Relat Cancer. 2010;17:265.Allolio B, Fassnacht M. Clinical review: Adrenocortical carcinoma: clinical update. JClinEndocrinolMetab. 2006;91:2027.Allolio B, Fassnacht M. Clinical review: Adrenocortical carcinoma: clinical update. JClinEndocrinolMetab. 2006;91:2027.Филимонюк А.В., Харченко Н.В., Леонов Б.И., Смирнова Е.А., АнтоновА.К., Смелкова Н.И.. Непосредственные и отдаленные результаты хирургического лечения больных адренокортикальным раком. Вестник новых медицинскихФилимонюк А.В., Харченко Н.В., Леонов Б.И., Смирнова Е.А., АнтоновА.К., Смелкова Н.И.. Непосредственные и отдаленные результаты хирургического лечения больных адренокортикальным раком. Вестник новых медицинскихтехнологий (электронное издание).2013;1[Электронный ресурс].технологий (электронное издание).2013;1[Электронный ресурс].Reibetanz J, Jurowich C, Erdogan I et al. Impact of lymphadenectomy on the oncologic outcome of patients with adrenocortical carcinoma. Ann Surg. 2012;255:363.Reibetanz J, Jurowich C, Erdogan I et al. Impact of lymphadenectomy on the oncologic outcome of patients with adrenocortical carcinoma. Ann Surg. 2012;255:363.Gaujoux S, Brennan MF. Recommendation for standardized surgical management of primary adrenocortical carcinoma. Surgery. 2012 152(1):123-32.Gaujoux S, Brennan MF. Recommendation for standardized surgical management of primary adrenocortical carcinoma. Surgery. 2012 152(1):123-32.Porpiglia F, Miller BS, Manfredi M et al. A debate on laparoscopic versus open adrenalectomy for adrenocortical carcinoma. Horm Cancer. 2011;2:372.Porpiglia F, Miller BS, Manfredi M et al. A debate on laparoscopic versus open adrenalectomy for adrenocortical carcinoma. Horm Cancer. 2011;2:372.Brix D, Allolio B, Fenske W et al. Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol. 2010;58:609.Brix D, Allolio B, Fenske W et al. Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol. 2010;58:609.Donatini G, Caiazzo R, Do Cao Ch et al. Long-Term Survival Aft er Adrenalectomy for Stage I/II Adrenocortical Carcinoma (ACC): A Retrospective Comparative Cohort Study of Laparoscopic Versus Open Approach. Ann Surg Oncol. 2014;21:284-291.Donatini G, Caiazzo R, Do Cao Ch et al. Long-Term Survival Aft er Adrenalectomy for Stage I/II Adrenocortical Carcinoma (ACC): A Retrospective Comparative Cohort Study of Laparoscopic Versus Open Approach. Ann Surg Oncol. 2014;21:284-291.McCauley LR, Nguyen MM. Laparoscopic radical adrenalectomy for cancer: long-term outcomes. Curr Opin Urol. 2008;18:134.McCauley LR, Nguyen MM. Laparoscopic radical adrenalectomy for cancer: long-term outcomes. Curr Opin Urol. 2008;18:134.Gonzalez RJ, Shapiro S, Sarlis N et al. Laparoscopic resection of adrenal cortical carcinoma: a cautionary note. Surgery.Gonzalez RJ, Shapiro S, Sarlis N et al. Laparoscopic resection of adrenal cortical carcinoma: a cautionary note. Surgery.;138(6):1078.;138(6):1078.Miller BS, Gauger PG, Hammer GD, Doherty GM. Resection of adrenocortical carcinoma is less complete and local recurrence occurs sooner and more oft en aft er laparoscopic adrenalectomy than aft er open adrenalectomy. Surgery. 2012;152:1150-1157.Miller BS, Gauger PG, Hammer GD, Doherty GM. Resection of adrenocortical carcinoma is less complete and local recurrence occurs sooner and more oft en aft er laparoscopic adrenalectomy than aft er open adrenalectomy. Surgery. 2012;152:1150-1157.Leboulleux S, Deandreis D, Ghuzlan A Al et al. Adrenocortical carcinoma: is the surgical approach a risk factor of peritoneal сarcinomatosis? Eur J Endocrinol. 2010;162:1147-1153Leboulleux S, Deandreis D, Ghuzlan A Al et al. Adrenocortical carcinoma: is the surgical approach a risk factor of peritoneal сarcinomatosis? Eur J Endocrinol. 2010;162:1147-1153Schulick RD, Brennan MF. Long-term survival aft er complete resection and repeat resection in patients with adrenocortical carcinoma. Ann Surg Oncol. 1999;6(8):719-726.Schulick RD, Brennan MF. Long-term survival aft er complete resection and repeat resection in patients with adrenocortical carcinoma. Ann Surg Oncol. 1999;6(8):719-726.Icard P, Chapuis Y, Andreassian B, et al. Adrenocortical carcinoma in surgically treated patients: a retrospective study on 156 cases by the French Association of Endocrine Surgery. Surgery. 1992;112(6):972-979.Icard P, Chapuis Y, Andreassian B, et al. Adrenocortical carcinoma in surgically treated patients: a retrospective study on 156 cases by the French Association of Endocrine Surgery. Surgery. 1992;112(6):972-979.Bellantone R, Ferrante A, Boscherini M, et al.: Role of reoperation in recurrence of adrenal cortical carcinoma: results from 188 cases collected in the Italian National Registry for Adrenal Cortical Carcinoma. Surgery. 1997,122:1212-1218.Bellantone R, Ferrante A, Boscherini M, et al.: Role of reoperation in recurrence of adrenal cortical carcinoma: results from 188 cases collected in the Italian National Registry for Adrenal Cortical Carcinoma. Surgery. 1997,122:1212-1218.Porpiglia F, Fiori C, Scarpa RM et al. Th e role of surgery in the management of recurrent adrenocortical carcinoma: results of a retrospective study. Eur Urol Suppl. 2009;8(4):305.Porpiglia F, Fiori C, Scarpa RM et al. Th e role of surgery in the management of recurrent adrenocortical carcinoma: results of a retrospective study. Eur Urol Suppl. 2009;8(4):305.Weiss LM. Comparative histologic study of 43 metastasizing and nonmetastasizing adrenocortical tumors. Am J Surg Pathol. 1984;8(3):163-169.Weiss LM. Comparative histologic study of 43 metastasizing and nonmetastasizing adrenocortical tumors. Am J Surg Pathol. 1984;8(3):163-169.Lau SK, Weiss LM. Th e Weiss system for evaluating adrenocortical neoplasms: 25 years later. Hum Pathol. 2009;40(6):757-768.Lau SK, Weiss LM. Th e Weiss system for evaluating adrenocortical neoplasms: 25 years later. Hum Pathol. 2009;40(6):757-768.van Slooten H, Schaberg A, Smeenk D, Moolenar AJ. Morphologic characteristics of benign and malignant adrenocortical tumors. Cancer. 1985 Feb 15;55(4):766-773.van Slooten H, Schaberg A, Smeenk D, Moolenar AJ. Morphologic characteristics of benign and malignant adrenocortical tumors. Cancer. 1985 Feb 15;55(4):766-773.Blanes Aet al. Histologic criteria for adrenocortical proliferative lesions: value of mitotic fi gure variability. Am J Clin Pathol. 2007;127(3):398-408.Blanes Aet al. Histologic criteria for adrenocortical proliferative lesions: value of mitotic fi gure variability. Am J Clin Pathol. 2007;127(3):398-408.Филиппова ОВ. Адренокортикальный рак: клинические проявления и морфологическая диагностика / Филиппова О.В., Хмельницкая Н.М. // Медицинский альманах. 2011;5:113-116.Филиппова ОВ. Адренокортикальный рак: клинические проявления и морфологическая диагностика / Филиппова О.В., Хмельницкая Н.М. // Медицинский альманах. 2011;5:113-116.Hahner S, Fassnacht M. Mitotane for adrenocortical carcinoma treatment. Curr Opin Investig Drugs.2005;6:386-394.Hahner S, Fassnacht M. Mitotane for adrenocortical carcinoma treatment. Curr Opin Investig Drugs.2005;6:386-394.Schteingart DE. Conventional and novel strategies in the treatment of adrenocortical cancer. Braz J Med Biol Res.2000;33:1197-1200.Schteingart DE. Conventional and novel strategies in the treatment of adrenocortical cancer. Braz J Med Biol Res.2000;33:1197-1200.Hague RV, May W, Cullen DR. Hepatic microsomal enzyme induction and adrenal crisis due to o,p_DDD therapy for metastatic adrenocortical carcinoma. Clin Endocrinol (Oxf).1989;31:51-57.Hague RV, May W, Cullen DR. Hepatic microsomal enzyme induction and adrenal crisis due to o,p_DDD therapy for metastatic adrenocortical carcinoma. Clin Endocrinol (Oxf).1989;31:51-57.Dickstein G. Is there a role of low dose of mitotane as adjuvant therapy in adrenocortical carcinoma? J Clin Endocrinol Metab.1999;84:1488-1489.Dickstein G. Is there a role of low dose of mitotane as adjuvant therapy in adrenocortical carcinoma? J Clin Endocrinol Metab.1999;84:1488-1489.Vassilopoulou-Sellin R, Guinee VF, Klein MJ, et al. Impact of adjuvant mitotane on the clinical course of patients with adrenocortical cancer. Cancer.1993;71:3119-3123.Vassilopoulou-Sellin R, Guinee VF, Klein MJ, et al. Impact of adjuvant mitotane on the clinical course of patients with adrenocortical cancer. Cancer.1993;71:3119-3123.Terzolo M, Angeli A, Fassnacht M Adjuvant mitotane treatment for adrenocortical carcinoma. N Engl J Med. 2007;356(23):2372.Terzolo M, Angeli A, Fassnacht M Adjuvant mitotane treatment for adrenocortical carcinoma. N Engl J Med. 2007;356(23):2372.Clinical trials gov. identifi er NCT00777244, start 2008, update 2013.Clinical trials gov. identifi er NCT00777244, start 2008, update 2013.Lubitz JA, Freeman L, Okun R Mitotane use in inoperable adrenalcortical carcinoma. JAMA.1973;223:1109-1112.Lubitz JA, Freeman L, Okun R Mitotane use in inoperable adrenalcortical carcinoma. JAMA.1973;223:1109-1112.van Slooten H, Moolenaar AJ, van Seters AP, Smeenk D. Th e treatment of adrenocortical carcinoma with o,p_-DDD:van Slooten H, Moolenaar AJ, van Seters AP, Smeenk D. Th e treatment of adrenocortical carcinoma with o,p_-DDD:prognostic implications of serum level monitoring. Eur J Cancer Clin Oncol.1984;20:47-53.prognostic implications of serum level monitoring. Eur J Cancer Clin Oncol.1984;20:47-53.Haak HR, Hermans J, van de Velde CJ et al. Optimal treatment of adrenocortical carcinoma with mitotane: results in a consecutive series of 96 patients. Br J Cancer.1994;69:947-951.Haak HR, Hermans J, van de Velde CJ et al. Optimal treatment of adrenocortical carcinoma with mitotane: results in a consecutive series of 96 patients. Br J Cancer.1994;69:947-951.Baudin E, Pellegriti G, Bonnay M et al. Impact of monitoring plasma 1,1-dichlorodiphenildichloroethane (o,p_DDD) levels on the treatment of patients with adrenocortical carcinoma. Cancer.2001;92:1385-1392.Baudin E, Pellegriti G, Bonnay M et al. Impact of monitoring plasma 1,1-dichlorodiphenildichloroethane (o,p_DDD) levels on the treatment of patients with adrenocortical carcinoma. Cancer.2001;92:1385-1392.Heilmann P, Wagner P, Nawroth PP, Ziegler R[Th erapy of the adrenocortical carcinoma with Lysodren (o,p’-DDD). Th erapeutic management by monitoring o,p_-DDD blood levels]. Med Klin.2001;96:371-377.Heilmann P, Wagner P, Nawroth PP, Ziegler R[Th erapy of the adrenocortical carcinoma with Lysodren (o,p’-DDD). Th erapeutic management by monitoring o,p_-DDD blood levels]. Med Klin.2001;96:371-377.Becker D, Schumacher OP. o,p’DDD therapy in invasive adrenocortical carcinoma. Ann Intern Med.1975;82:677-679.Becker D, Schumacher OP. o,p’DDD therapy in invasive adrenocortical carcinoma. Ann Intern Med.1975;82:677-679.Boven E, Vermorken JB, van Slooten H, PinedoHM. Complete response of metastasized adrenal cortical carcinoma with o,p_- DDD. Case report and literature review. Cancer.1984;53:26-29.Boven E, Vermorken JB, van Slooten H, PinedoHM. Complete response of metastasized adrenal cortical carcinoma with o,p_- DDD. Case report and literature review. Cancer.1984;53:26-29.Krzisnik C, Petric G, Jereb B. Complete response of metastatic adrenal cortical carcinoma to o,p_-DDD in a child. Pediatr Hematol Oncol.1988;5:65-69.Krzisnik C, Petric G, Jereb B. Complete response of metastatic adrenal cortical carcinoma to o,p_-DDD in a child. Pediatr Hematol Oncol.1988;5:65-69.Lim MC, Tan YO, Chong PY, Cheah JS. Treatment of adrenal cortical carcinoma with mitotane: outcome and complications. Ann Acad Med Singapore.1990.Lim MC, Tan YO, Chong PY, Cheah JS. Treatment of adrenal cortical carcinoma with mitotane: outcome and complications. Ann Acad Med Singapore.1990.Decker RA, Kuehner ME. Adrenocortical carcinoma. Am Surg.1991;57:502-513.Decker RA, Kuehner ME. Adrenocortical carcinoma. Am Surg.1991;57:502-513.Remond S, Bardet S, Charbonnel B. Complete and lasting remission of a metastatic malignant adrenocortical carcinoma under treatment with OP- _DDD alone. Presse Med.1992;21:865.Remond S, Bardet S, Charbonnel B. Complete and lasting remission of a metastatic malignant adrenocortical carcinoma under treatment with OP- _DDD alone. Presse Med.1992;21:865.Ilias I, Alevizaki M, Philippou G, Anastasiou E, Souvatzoglou A. Sustained remission of metastatic adrenal carcinoma during long-term administration of low-dose mitotane. J Endocrinol Invest.2001;24:532-535.Ilias I, Alevizaki M, Philippou G, Anastasiou E, Souvatzoglou A. Sustained remission of metastatic adrenal carcinoma during long-term administration of low-dose mitotane. J Endocrinol Invest.2001;24:532-535.Allolio B, Hahner S, Weismann D, Fassnacht M. Management of adrenocortical carcinoma. Clin Endocrinol (Oxf).2004;60:273- 287. 19:540-544.Allolio B, Hahner S, Weismann D, Fassnacht M. Management of adrenocortical carcinoma. Clin Endocrinol (Oxf).2004;60:273- 287. 19:540-544.Fassnacht M, Libe R, Kroiss M, Allolio B. Adrenocortical carcinoma: a clinician’s update. Nat Rev Endocrinol. 2011;7:323.Fassnacht M, Libe R, Kroiss M, Allolio B. Adrenocortical carcinoma: a clinician’s update. Nat Rev Endocrinol. 2011;7:323.Cordon-Cardo C, O’Brien JP, Boccia J et al. Expression of the multidrug resistance gene product (P-glycoprotein)Cordon-Cardo C, O’Brien JP, Boccia J et al. Expression of the multidrug resistance gene product (P-glycoprotein)in human normal and tumor tissues. J Histochem Cytochem.1990;38:1277-1287.in human normal and tumor tissues. J Histochem Cytochem.1990;38:1277-1287.Flynn SD, Murren JR, Kirby WM et al.P-glycoprotein expression and multidrug resistance in adrenocortical carcinoma.Flynn SD, Murren JR, Kirby WM et al.P-glycoprotein expression and multidrug resistance in adrenocortical carcinoma.Surgery.1992;112:981-986.Surgery.1992;112:981-986.Goldstein LJ, Galski H, Fojo A, et al. Expression of a multidrug resistance gene in human cancers. J Natl Cancer Inst.1989;81:116-124.Goldstein LJ, Galski H, Fojo A, et al. Expression of a multidrug resistance gene in human cancers. J Natl Cancer Inst.1989;81:116-124.Fridborg H, Larsson R, Juhlin C, Rastad J, Akerstrom G, Backlin K, Nygren PP-glycoprotein expression and activity of resistance modifying agents in primary cultures of human renal and adrenocortical carcinoma cells. An-ticancer Res.1994;14:1009-1016.Fridborg H, Larsson R, Juhlin C, Rastad J, Akerstrom G, Backlin K, Nygren PP-glycoprotein expression and activity of resistance modifying agents in primary cultures of human renal and adrenocortical carcinoma cells. An-ticancer Res.1994;14:1009-1016.Haak HR, van Seters AP, Moolenaar AJ, Fleuren GJ Expression of P-glycoprotein in relation to clinical manifestation, treatment and prognosis of adrenocortical cancer. Eur J Cancer.1993;29A:1036-1038.Haak HR, van Seters AP, Moolenaar AJ, Fleuren GJ Expression of P-glycoprotein in relation to clinical manifestation, treatment and prognosis of adrenocortical cancer. Eur J Cancer.1993;29A:1036-1038.Fassnacht M, Terzolo M, Allolio B et al. Combination chemotherapy in advanced adrenocortical carcinoma. FIRMACT Study GroupN Engl J Med. 2012;366(23):2189.Fassnacht M, Terzolo M, Allolio B et al. Combination chemotherapy in advanced adrenocortical carcinoma. FIRMACT Study GroupN Engl J Med. 2012;366(23):2189.Martin Fassnacht, Matthias Kroiss, and Bruno Allolio. Update in Adrenocortical Carcinoma. J Clin Endocrinol Metab. 2013, 98(12):4551-4564.Martin Fassnacht, Matthias Kroiss, and Bruno Allolio. Update in Adrenocortical Carcinoma. J Clin Endocrinol Metab. 2013, 98(12):4551-4564.Icard P, Goudet P, Charpenay C. Adrenocortical carcinomas: surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons Study Group. World J Surg.2001;25:891-897.Icard P, Goudet P, Charpenay C. Adrenocortical carcinomas: surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons Study Group. World J Surg.2001;25:891-897.Crucitti F, Bellantone R, Ferrante A, et al. Th e Italian Registry for Adrenal Cortical Carcinoma: analysis of a multiinstitutional series of 129 patients. Th e ACC Italian Registry Study Group. Surgery.1996;119:161-170.Crucitti F, Bellantone R, Ferrante A, et al. Th e Italian Registry for Adrenal Cortical Carcinoma: analysis of a multiinstitutional series of 129 patients. Th e ACC Italian Registry Study Group. Surgery.1996;119:161-170.Pommier RF, Brennan MF. An eleven-year experience with adrenocortical carcinoma. Surgery 1992;112:963-970; discussion, 970-971.Pommier RF, Brennan MF. An eleven-year experience with adrenocortical carcinoma. Surgery 1992;112:963-970; discussion, 970-971.Soreide JA, Brabrand K, Th oresen SO. Adrenal cortical carcinoma in Norway, 1970–1984. World J Surg.1992;16:663- 667; discussion, 668.Soreide JA, Brabrand K, Th oresen SO. Adrenal cortical carcinoma in Norway, 1970–1984. World J Surg.1992;16:663- 667; discussion, 668.Vassilopoulou-Sellin R, Schultz PN. Adrenocortical carcinoma. Clinical outcome at the end of the 20th century. Cancer.2001;92:1113-1121.Vassilopoulou-Sellin R, Schultz PN. Adrenocortical carcinoma. Clinical outcome at the end of the 20th century. Cancer.2001;92:1113-1121.

The authors declare that there are no conflicts of interest present.