Castration failure in prostate carcinoma due to a functioning adrenocortical carcinoma

Vishal Navani; James F Lynam; Steven Smith; Christine J O’Neill; Christopher W Rowe

doi:10.1530/EDM-21-0036

Endocrinology, Diabetes & Metabolism Case Reports (Oct 2021)

Castration failure in prostate carcinoma due to a functioning adrenocortical carcinoma

Vishal Navani,
James F Lynam,
Steven Smith,
Christine J O’Neill,
Christopher W Rowe

Affiliations

Vishal Navani: Department of Medical Oncology, Calvary Mater Hospital, Newcastle, New South Wales, Australia
James F Lynam: Department of Medical Oncology, Calvary Mater Hospital, Newcastle, New South Wales, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
Steven Smith: Department of Nuclear Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
Christine J O’Neill: School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia; University of Newcastle, Newcastle, New South Wales, Australia
Christopher W Rowe: School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Department of Endocrinology, John Hunter Hospital, Newcastle, New South Wales, Australia

DOI: https://doi.org/10.1530/EDM-21-0036
Journal volume & issue: Vol. 1, no. 1
pp. 1 – 6

Abstract

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We report concurrent metastatic prostatic adenocarcinoma (PC) and functioning androgen-secreting adrenocortical carcinoma (ACC) in a 77-year-old man. The failure to achieve adequate biochemical castration via androgen deprivation therapy (ADT) as treatment for PC metastases, together with elevated DHEA-S, androstenedione, and discordant adrenal tracer uptake on FDG-PET and PSMA-PET, suggested the presence of a concurrent functional primary adrenal malignancy. On histopathological analysis, scant foci of PC were present throughout the ACC specimen. Castration was achieved post adrenalectomy with concurrent drop in prostate-specific antigen. We outline the literature regarding failure of testosterone suppression on ADT and salient points regarding diagnostic workup of functioning adrenal malignancies.

Published in Endocrinology, Diabetes & Metabolism Case Reports

ISSN: 2052-0573 (Online)
Publisher: Bioscientifica
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://edm.bioscientifica.com/

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