Management of Severe Cushing Syndrome Induced by Adrenocortical Carcinoma with Abiraterone Acetate: A Case Report

ABSTRACT Objective: Adrenocortical carcinoma (ACC) is a rare disease often associated with hormonal hypersecretion. Hypercortisolism is the most common endocrine syndrome associated with ACC. Abiraterone acetate is a selective and irreversible inhibitor of cytochrome P450 17A1 that is currently used in the treatment of metastatic castration-resistant prostate cancer. The drug induces a profound suppression of both androgen and cortisol secretion and it is a plausible candidate for medical treatment of Cushing's syndrome. We evaluated the hormonal effects of abiraterone administration in a patient with Cushing's syndrome induced by heavily pre-treated metastatic ACC. Methods: A 50-year-old woman with ACC, suffering from severe and unmanageable Cushing's syndrome despite mitotane therapy, received oral abiraterone at 500 mg/day. Results: After 9 days of treatment, the patient experienced a dramatic improvement in autonomy and deambulation, reduction of edema, better control of blood pressure and glycemia, s...