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Mitotane in the Treatment of Childhood Adrenocortical Carcinoma: a Potent Endocrine Disruptor

Overview
Journal Endocrinol Diabetes Metab Case Rep
Specialty Endocrinology
Date 2018 Aug 31
PMID 30159150
Citations 10
Authors
Philip D Oddie
Benjamin B Albert
Paul L Hofman
Craig Jefferies
Stephen Laughton
Philippa J Carter
Affiliations
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Abstract

Learning Points: Adrenocortical carcinoma is an important differential diagnosis for virilization in young childrenMitotane is a chemotherapeutic agent that is used to treat adrenocortical carcinoma and causes adrenal necrosisMitotane is an endocrine disruptor. In addition to the intended effect of adrenal insufficiency, it can cause hypothyroidism, with gynecomastia also reported in adults.Patients taking mitotane require very high doses of hydrocortisone replacement therapy because mitotane interferes with steroid metabolism. This effect persists after mitotane therapy is completedIn our case, mitotane caused peripheral precocious puberty, possibly through its estrogenic effect.

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