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Diagnosis and Management of Adrenocortical Carcinomas

  • Chapter
Neuroendocrine Tumours

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Abstract

Adrenocortical carcinomas (ACC) are rare tumors with unfavorable prognosis; they may be functional (hormone secreting) or nonfunctional. The estimated incidence is 1–2 per million per population and the overall 5-year survival is less than 40 %. Surgery is the mainstay of treatment in patients with localized disease, and metastasectomy can be performed in selected cases. Mitotane is a derivative of the insecticide dichlorodiphenyltrichloroethane and has been used in adjuvant, locally advanced, and metastatic setting in the treatment of ACC. Adjuvant therapy with mitotane after surgical excision is recommended in high-risk cases. In metastatic or unresectable disease, mitotane can be used alone or in combination with chemotherapy. Radiotherapy is usually utilized with palliative intent; recent retrospective studies also showed benefit of postoperative radiotherapy. Targeted therapies with tyrosine kinase inhibitors, vascular endothelial growth factor receptor inhibitors, or mTOR inhibitors alone or in combination are still under investigation.

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References

  1. Abecassis M, McLoughlin MJ, Langer B, Kudlow JE (1985) Serendipitous adrenal masses: prevalence, significance, and management. Am J Surg 149(6):783–788

    Article  CAS  PubMed  Google Scholar 

  2. Bovio S, Cataldi A, Reimondo G et al (2006) Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest 29(4):298–302

    Article  CAS  PubMed  Google Scholar 

  3. Vassilopoulou-Sellin R, Schultz PN (2001) Adrenocortical carcinoma. Clinical outcome at the end of the 20th century. Cancer 92(5):1113–1121

    Article  CAS  PubMed  Google Scholar 

  4. Fassnacht M, Libe R, Kroiss M, Allolio B (2011) Adrenocortical carcinoma: a clinician’s update. Nat Rev Endocrinol 7(6):323–335

    Article  CAS  PubMed  Google Scholar 

  5. Allolio B, Fassnacht M (2006) Clinical review: adrenocortical carcinoma: clinical update. J Clin Endocrinol Metab 91(6):2027–2037

    Article  CAS  PubMed  Google Scholar 

  6. Bilimoria KY, Shen WT, Elaraj D et al (2008) Adrenocortical carcinoma in the United States: treatment utilization and prognostic factors. Cancer 113(11):3130–3136

    Article  PubMed  Google Scholar 

  7. Crucitti F, Bellantone R, Ferrante A, Boscherini M, Crucitti P (1996) The Italian Registry for Adrenal Cortical Carcinoma: analysis of a multi-institutional series of 129 patients. The ACC Italian Registry Study Group. Surgery 119(2):161–170

    Article  CAS  PubMed  Google Scholar 

  8. Icard P, Goudet P, Charpenay C et al (2001) Adrenocortical carcinomas: surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons study group. World J Surg 25(7):891–897

    Article  CAS  PubMed  Google Scholar 

  9. Kasperlik-Zaluska AA, Migdalska BM, Zgliczynski S, Makowska AM (1995) Adrenocortical carcinoma. A clinical study and treatment results of 52 patients. Cancer 75(10):2587–2591

    Article  CAS  PubMed  Google Scholar 

  10. Busaidy NL, Habra MA, Sellin RV (2011) Endocrine malignancies. In: Kantarjian Hahop M, Wolf Robert A, Charles Koller A (eds) Manual of medical oncology, 2nd edn. MCGraw Hill, New York, USA, pp 1039–1076

    Google Scholar 

  11. Kasperlik-Zeluska AA, Roslonowska E, Slowinska-Srzednicka J et al (1997) Incidentally discovered adrenal mass (incidentaloma): investigation and management of 208 patients. Clin Endocrinol (Oxf) 46(1):29–37

    Article  CAS  Google Scholar 

  12. Henley DJ, van Heerden JA, Grant CS, Carney JA, Carpenter PC (1983) Adrenal cortical carcinoma–a continuing challenge. Surgery 94(6):926–931

    CAS  PubMed  Google Scholar 

  13. Luton JP, Cerdas S, Billaud L et al (1990) Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy. N Engl J Med 322(17):1195–1201

    Article  CAS  PubMed  Google Scholar 

  14. Herrmann LJ, Heinze B, Fassnacht M et al (2012) TP53 germline mutations in adult patients with adrenocortical carcinoma. J Clin Endocrinol Metab 97(3):E476–E485

    Article  CAS  PubMed  Google Scholar 

  15. Raymond VM, Else T, Everett JN, Long JM, Gruber SB, Hammer GD (2013) Prevalence of germline TP53 mutations in a prospective series of unselected patients with adrenocortical carcinoma. J Clin Endocrinol Metab 98(1):E119–E125

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Gicquel C, Bertagna X, Gaston V et al (2001) Molecular markers and long-term recurrences in a large cohort of patients with sporadic adrenocortical tumors. Cancer Res 61(18):6762–6767

    CAS  PubMed  Google Scholar 

  17. Gicquel C, Bertagna X, Schneid H et al (1994) Rearrangements at the 11p15 locus and overexpression of insulin-like growth factor-II gene in sporadic adrenocortical tumors. J Clin Endocrinol Metab 78(6):1444–1453

    CAS  PubMed  Google Scholar 

  18. de Fraipont F, El Atifi M, Cherradi N et al (2005) Gene expression profiling of human adrenocortical tumors using complementary deoxyribonucleic acid microarrays identifies several candidate genes as markers of malignancy. J Clin Endocrinol Metab 90(3):1819–1829

    Article  PubMed  Google Scholar 

  19. Giordano TJ, Thomas DG, Kuick R et al (2003) Distinct transcriptional profiles of adrenocortical tumors uncovered by DNA microarray analysis. Am J Pathol 162(2):521–531

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Slater EP, Diehl SM, Langer P et al (2006) Analysis by cDNA microarrays of gene expression patterns of human adrenocortical tumors. Eur J Endocrinol 154(4):587–598

    Article  CAS  PubMed  Google Scholar 

  21. Boulle N, Logie A, Gicquel C, Perin L, Le Bouc Y (1998) Increased levels of insulin-like growth factor II (IGF-II) and IGF-binding protein-2 are associated with malignancy in sporadic adrenocortical tumors. J Clin Endocrinol Metab 83(5):1713–1720

    CAS  PubMed  Google Scholar 

  22. Gaujoux S, Grabar S, Fassnacht M et al (2011) β-catenin activation is associated with specific clinical and pathologic characteristics and a poor outcome in adrenocortical carcinoma. Clin Cancer Res 17(2):328–336

    Article  CAS  PubMed  Google Scholar 

  23. Assie G, Letouze E, Fassnacht M et al (2014) Integrated genomic characterization of adrenocortical carcinoma. Nat Genet 46(6):607–612

    Article  CAS  PubMed  Google Scholar 

  24. Gupta D, Shidham V, Holden J, Layfield L (2001) Value of topoisomerase II alpha, MIB-1, p53, E-cadherin, retinoblastoma gene protein product, and HER-2/neu immunohistochemical expression for the prediction of biologic behavior in adrenocortical neoplasms. Appl Immunohistochem Mol Morphol 9(3):215–221

    CAS  PubMed  Google Scholar 

  25. Schmitt A, Saremaslani P, Schmid S et al (2006) IGFII and MIB1 immunohistochemistry is helpful for the differentiation of benign from malignant adrenocortical tumours. Histopathology 49(3):298–307

    Article  CAS  PubMed  Google Scholar 

  26. Stojadinovic A, Brennan MF, Hoos A et al (2003) Adrenocortical adenoma and carcinoma: histopathological and molecular comparative analysis. Mod Pathol 16(8):742–751

    Article  PubMed  Google Scholar 

  27. Volante M, Sperone P, Bollito E et al (2006) Matrix metalloproteinase type 2 expression in malignant adrenocortical tumors: diagnostic and prognostic significance in a series of 50 adrenocortical carcinomas. Mod Pathol 19(12):1563–1569

    Article  CAS  PubMed  Google Scholar 

  28. Kjellman M, Enberg U, Hoog A et al (1999) Gelatinase A and membrane-type 1 matrix metalloproteinase mRNA: expressed in adrenocortical cancers but not in adenomas. World J Surg 23(3):237–242

    Article  CAS  PubMed  Google Scholar 

  29. Kolomecki K, Stepien H, Bartos M, Kuzdak K (2001) Usefulness of VEGF, MMP-2, MMP-3 and TIMP-2 serum level evaluation in patients with adrenal tumours. Endocr Regul 35(1):9–16

    CAS  PubMed  Google Scholar 

  30. Fassnacht M, Allolio B (2009) Clinical management of adrenocortical carcinoma. Best Pract Res Clin Endocrinol Metab 23(2):273–289

    Article  CAS  PubMed  Google Scholar 

  31. Arlt W, Biehl M, Taylor AE et al (2011) Urine steroid metabolomics as a biomarker tool for detecting malignancy in adrenal tumors. J Clin Endocrinol Metab 96(12):3775–3784

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Dackiw AP, Lee JE, Gagel RF, Evans DB (2001) Adrenal cortical carcinoma. World J Surg 25(7):914–926

    Article  CAS  PubMed  Google Scholar 

  33. Caoili EM, Korobkin M, Francis IR, Cohan RH, Dunnick NR (2000) Delayed enhanced CT of lipid-poor adrenal adenomas. AJR Am J Roentgenol 175(5):1411–1415

    Article  CAS  PubMed  Google Scholar 

  34. Lee MJ, Hahn PF, Papanicolaou N et al (1991) Benign and malignant adrenal masses: CT distinction with attenuation coefficients, size, and observer analysis. Radiology 179(2):415–418

    Article  CAS  PubMed  Google Scholar 

  35. Pena CS, Boland GW, Hahn PF, Lee MJ, Mueller PR (2000) Characterization of indeterminate (lipid-poor) adrenal masses: use of washout characteristics at contrast-enhanced CT. Radiology 217(3):798–802

    Article  CAS  PubMed  Google Scholar 

  36. Boland GW, Dwamena BA, Jagtiani Sangwaiya M et al (2011) Characterization of adrenal masses by using FDG PET: a systematic review and meta-analysis of diagnostic test performance. Radiology 259(1):117–126

    Article  PubMed  Google Scholar 

  37. Boland GW, Goldberg MA, Lee MJ et al (1995) Indeterminate adrenal mass in patients with cancer: evaluation at PET with 2-[F-18]-fluoro-2-deoxy-D-glucose. Radiology 194(1):131–134

    Article  CAS  PubMed  Google Scholar 

  38. Erasmus JJ, Patz EF Jr, McAdams HP et al (1997) Evaluation of adrenal masses in patients with bronchogenic carcinoma using 18F-fluorodeoxyglucose positron emission tomography. AJR Am J Roentgenol 168(5):1357–1360

    Article  CAS  PubMed  Google Scholar 

  39. Cote R, Suster S, Weiss L, Weidner N (eds) (2002) Modern surgical pathology (2 volume set). W B Saunders, London

    Google Scholar 

  40. Soon PS, Gill AJ, Benn DE et al (2009) Microarray gene expression and immunohistochemistry analyses of adrenocortical tumors identify IGF2 and Ki-67 as useful in differentiating carcinomas from adenomas. Endocr Relat Cancer 16(2):573–583

    Article  CAS  PubMed  Google Scholar 

  41. Aubert S, Wacrenier A, Leroy X et al (2002) Weiss system revisited: a clinicopathologic and immunohistochemical study of 49 adrenocortical tumors. Am J Surg Pathol 26(12):1612–1619

    Article  PubMed  Google Scholar 

  42. Weiss LM (1984) Comparative histologic study of 43 metastasizing and non-metastasizing adrenocortical tumors. Am J Surg Pathol 8(3):163–169

    Article  CAS  PubMed  Google Scholar 

  43. Macfarlane DA (1958) Cancer of the adrenal cortex; the natural history, prognosis and treatment in a study of fifty-five cases. Ann R Coll Surg Engl 23(3):155–186

    PubMed Central  CAS  PubMed  Google Scholar 

  44. Sullivan M, Boileau M, Hodges CV (1978) Adrenal cortical carcinoma. J Urol 120(6):660–665

    CAS  PubMed  Google Scholar 

  45. Lee JE, Berger DH, el-Naggar AK et al (1995) Surgical management, DNA content, and patient survival in adrenal cortical carcinoma. Surgery 118(6):1090–1098

    Article  CAS  PubMed  Google Scholar 

  46. Edge SB, Byrd DR, Compton CC et al (eds) (2010) In adrenal. AJCC cancer staging manual, 7th edn. Springer, New York, pp 515–520

    Google Scholar 

  47. Fassnacht M, Johanssen S, Quinkler M et al (2009) Limited prognostic value of the 2004 International Union Against Cancer staging classification for adrenocortical carcinoma: proposal for a Revised TNM Classification. Cancer 115(2):243–250

    Article  PubMed  Google Scholar 

  48. Polat B, Fassnacht M, Pfreundner L et al (2009) Radiotherapy in adrenocortical carcinoma. Cancer 115(13):2816–2823

    Article  PubMed  Google Scholar 

  49. Doppman JL, Reinig JW, Dwyer AJ et al (1987) Differentiation of adrenal masses by magnetic resonance imaging. Surgery 102(6):1018–1026

    CAS  PubMed  Google Scholar 

  50. Kopf D, Goretzki PE, Lehnert H (2001) Clinical management of malignant adrenal tumors. J Cancer Res Clin Oncol 127(3):143–155

    Article  CAS  PubMed  Google Scholar 

  51. Shen WT, Sturgeon C, Duh QY (2005) From incidentaloma to adrenocortical carcinoma: the surgical management of adrenal tumors. J Surg Oncol 89(3):186–192

    Article  PubMed  Google Scholar 

  52. Neuroendocrine tumors. NCCN Guidelines Version 2.2014. Accessed 22 Aug 22 2014

    Google Scholar 

  53. Iino K, Oki Y, Sasano H (2000) A case of adrenocortical carcinoma associated with recurrence after laparoscopic surgery. Clin Endocrinol (Oxf) 53(2):243–248

    Article  CAS  Google Scholar 

  54. Schlamp A, Hallfeldt K, Mueller-Lisse U, Pfluger T, Reincke M (2007) Recurrent adrenocortical carcinoma after laparoscopic resection. Nat Clin Pract Endocrinol Metab 3(2):191–195; quiz 1 p following 5

    Article  PubMed  Google Scholar 

  55. Ushiyama T, Suzuki K, Kageyama S, Fujita K, Oki Y, Yoshimi T (1997) A case of Cushing’s syndrome due to adrenocortical carcinoma with recurrence 19 months after laparoscopic adrenalectomy. J Urol 157(6):2239

    Article  CAS  PubMed  Google Scholar 

  56. Gonzalez RJ, Shapiro S, Sarlis N et al (2005) Laparoscopic resection of adrenal cortical carcinoma: a cautionary note. Surgery 138(6):1078–1085; discussion 85–86

    Article  PubMed  Google Scholar 

  57. Miller BS, Ammori JB, Gauger PG, Broome JT, Hammer GD, Doherty GM (2010) Laparoscopic resection is inappropriate in patients with known or suspected adrenocortical carcinoma. World J Surg 34(6):1380–1385

    Article  CAS  PubMed  Google Scholar 

  58. Brix D, Allolio B, Fenske W et al (2010) Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol 58(4):609–615

    Article  PubMed  Google Scholar 

  59. Terzolo M, Berruti A (2008) Adjunctive treatment of adrenocortical carcinoma. Curr Opin Endocrinol Diabetes Obes 15(3):221–226

    Article  CAS  PubMed  Google Scholar 

  60. Schulick RD, Brennan MF (1999) Long-term survival after complete resection and repeat resection in patients with adrenocortical carcinoma. Ann Surg Oncol 6(8):719–726

    Article  CAS  PubMed  Google Scholar 

  61. van Ditzhuijsen CI, van de Weijer R, Haak HR (2007) Adrenocortical carcinoma. Neth J Med 65(2):55–60

    PubMed  Google Scholar 

  62. Terzolo M, Angeli A, Fassnacht M et al (2007) Adjuvant mitotane treatment for adrenocortical carcinoma. N Engl J Med 356(23):2372–2380

    Article  CAS  PubMed  Google Scholar 

  63. Berruti A, Fassnacht M, Baudin E et al (2010) Adjuvant therapy in patients with adrenocortical carcinoma: a position of an international panel. J Clin Oncol 28(23):e401–e402; author reply e3

    Article  PubMed  Google Scholar 

  64. Bourdeau I, MacKenzie-Feder J, Lacroix A (2013) Recent advances in adrenocortical carcinoma in adults. Curr Opin Endocrinol Diabetes Obes 20(3):192–197

    Article  CAS  PubMed  Google Scholar 

  65. Zini L, Porpiglia F, Fassnacht M (2011) Contemporary management of adrenocortical carcinoma. Eur Urol 60(5):1055–1065

    Article  PubMed  Google Scholar 

  66. Baudin E, Pellegriti G, Bonnay M et al (2001) Impact of monitoring plasma 1,1-dichlorodiphenildichloroethane (o, p'DDD) levels on the treatment of patients with adrenocortical carcinoma. Cancer 92(6):1385–1392

    Article  CAS  PubMed  Google Scholar 

  67. Kroiss M, Quinkler M, Lutz WK, Allolio B, Fassnacht M (2011) Drug interactions with mitotane by induction of CYP3A4 metabolism in the clinical management of adrenocortical carcinoma. Clin Endocrinol (Oxf) 75(5):585–591

    Article  CAS  Google Scholar 

  68. Ronchi CL, Kroiss M, Sbiera S, Deutschbein T, Fassnacht M (2014) EJE prize 2014, current and evolving treatment options in adrenocortical carcinoma: where do we stand and where do we want to go? Eur J Endocrinol 171(1):R1–R11

    Article  CAS  PubMed  Google Scholar 

  69. Berruti A, Terzolo M, Sperone P et al (2005) Etoposide, doxorubicin and cisplatin plus mitotane in the treatment of advanced adrenocortical carcinoma: a large prospective phase II trial. Endocr Relat Cancer 12(3):657–666

    Article  CAS  PubMed  Google Scholar 

  70. Khan TS, Imam H, Juhlin C et al (2000) Streptozocin and o, p'DDD in the treatment of adrenocortical cancer patients: long-term survival in its adjuvant use. Ann Oncol 11(10):1281–1287

    Article  CAS  PubMed  Google Scholar 

  71. Schteingart DE, Doherty GM, Gauger PG et al (2005) Management of patients with adrenal cancer: recommendations of an international consensus conference. Endocr Relat Cancer 12(3):667–680

    Article  CAS  PubMed  Google Scholar 

  72. Fassnacht M, Terzolo M, Allolio B et al (2012) Combination chemotherapy in advanced adrenocortical carcinoma. N Engl J Med 366(23):2189–2197

    Article  CAS  PubMed  Google Scholar 

  73. Sperone P, Ferrero A, Daffara F et al (2010) Gemcitabine plus metronomic 5-fluorouracil or capecitabine as a second-/third-line chemotherapy in advanced adrenocortical carcinoma: a multicenter phase II study. Endocr Relat Cancer 17(2):445–453

    Article  CAS  PubMed  Google Scholar 

  74. Lebastchi AH, Kunstman JW, Carling T (2012) Adrenocortical carcinoma: current therapeutic state-of-the-art. J Oncol 2012:234726

    Article  PubMed Central  PubMed  Google Scholar 

  75. Fassnacht M, Hahner S, Polat B et al (2006) Efficacy of adjuvant radiotherapy of the tumor bed on local recurrence of adrenocortical carcinoma. J Clin Endocrinol Metab 91(11):4501–4504

    Article  CAS  PubMed  Google Scholar 

  76. Sabolch A, Feng M, Griffith K, Hammer G, Doherty G, Ben-Josef E (2011) Adjuvant and definitive radiotherapy for adrenocortical carcinoma. Int J Radiat Oncol Biol Phys 80(5):1477–1484

    Article  PubMed  Google Scholar 

  77. Habra MA, Ejaz S, Feng L et al (2013) A retrospective cohort analysis of the efficacy of adjuvant radiotherapy after primary surgical resection in patients with adrenocortical carcinoma. J Clin Endocrinol Metab 98(1):192–197

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  78. Glover AR, Ip JC, Zhao JT, Soon PS, Robinson BG, Sidhu SB (2013) Current management options for recurrent adrenocortical carcinoma. Onco Targets Ther 6:635–643

    PubMed Central  PubMed  Google Scholar 

  79. Wood BJ, Abraham J, Hvizda JL, Alexander HR, Fojo T (2003) Radiofrequency ablation of adrenal tumors and adrenocortical carcinoma metastases. Cancer 97(3):554–560

    Article  PubMed Central  PubMed  Google Scholar 

  80. Datrice NM, Langan RC, Ripley RT et al (2012) Operative management for recurrent and metastatic adrenocortical carcinoma. J Surg Oncol 105(7):709–713

    Article  PubMed Central  PubMed  Google Scholar 

  81. Quinkler M, Hahner S, Wortmann S et al (2008) Treatment of advanced adrenocortical carcinoma with erlotinib plus gemcitabine. J Clin Endocrinol Metab 93(6):2057–2062

    Article  CAS  PubMed  Google Scholar 

  82. Wortmann S, Quinkler M, Ritter C et al (2010) Bevacizumab plus capecitabine as a salvage therapy in advanced adrenocortical carcinoma. Eur J Endocrinol 162(2):349–356

    Article  CAS  PubMed  Google Scholar 

  83. Berruti A, Sperone P, Ferrero A et al (2012) Phase II study of weekly paclitaxel and sorafenib as second/third-line therapy in patients with adrenocortical carcinoma. Eur J Endocrinol 166(3):451–458

    Article  CAS  PubMed  Google Scholar 

  84. Kroiss M, Quinkler M, Johanssen S et al (2012) Sunitinib in refractory adrenocortical carcinoma: a phase II, single-arm, open-label trial. J Clin Endocrinol Metab 97(10):3495–3503

    Article  CAS  PubMed  Google Scholar 

  85. Carden CP, Frentzas S, Langham M (2009) Preliminary activity in adrenocortical tumor (ACC) in phase I dose escalation study of intermittent oral dosing of OSI-906, a small-molecule insulin-like growth factor-1 receptor (IGF-1R) tyrosine kinase inhibitor in patients with advanced solid tumors. J Clin Oncol 27(15S):abstr 3544

    Google Scholar 

  86. Memmott RM, Dennis PA (2009) Akt-dependent and -independent mechanisms of mTOR regulation in cancer. Cell Signal 21(5):656–664

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  87. Fraenkel M, Gueorguiev M, Barak D, Salmon A, Grossman AB, Gross DJ (2013) Everolimus therapy for progressive adrenocortical cancer. Endocrine 44(1):187–192

    Article  CAS  PubMed  Google Scholar 

  88. Naing A, Lorusso P, Fu S et al (2013) Insulin growth factor receptor (IGF-1R) antibody cixutumumab combined with the mTOR inhibitor temsirolimus in patients with metastatic adrenocortical carcinoma. Br J Cancer 108(4):826–830

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  89. Doghman M, Cazareth J, Douguet D, Madoux F, Hodder P, Lalli E (2009) Inhibition of adrenocortical carcinoma cell proliferation by steroidogenic factor-1 inverse agonists. J Clin Endocrinol Metab 94(6):2178–2183

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  90. Edge SB, Byrd DR, Compton CC et al (2010) AJCC Cancer Staging Manual: Adrenal. 7th ed. New York, NY: Springer, 2010, pp. 515–520

    Google Scholar 

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Authors and Affiliations

  1. Medical Oncology Department, Acibadem University, Bursa, Turkey

    Bulent Orhan MD

  2. Preventive Oncology Department, Institute of Cancer, Hacettepe University, Ankara, Turkey

    Omer Dizdar MD

  3. Medical Oncology Department, Institute of Cancer, Hacettepe University, Sihhiye, Ankara, Turkey

    Suayib Yalcin MD

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  1. Bulent Orhan MD
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Correspondence to Suayib Yalcin MD .

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  1. Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey

    Suayib Yalcin

  2. Department of Endocrine Oncology, Uppsala University Hospital, Uppsala, Sweden

    Kjell Öberg

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Orhan, B., Dizdar, O., Yalcin, S. (2015). Diagnosis and Management of Adrenocortical Carcinomas. In: Yalcin, S., Öberg, K. (eds) Neuroendocrine Tumours. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45215-8_23

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