A case of local advanced adrenocortical cancer with a long‐term recurrence‐free survival treated with complete surgical excision and adjuvant therapy with a very low‐dose mitotane

Introduction Adrenocortical cancer is a rare tumor with high malignant potential, often resulting in recurrence and poor survival even after complete excision. Thus, adjuvant therapy needs to be considered despite its unestablished effectiveness. Case presentation We report a 70-year-old man presented with a huge adrenal mass extending into the right liver lobe. He underwent right adrenalectomy concurrent with right nephrectomy and right hemihepatectomy for curative intent. He was given a very low-dose mitotane (0.5 g/day) adjuvant therapy to be alive without any signs of recurrence for 90 months after surgery without unwanted toxicity. Conclusion A long-term and very low dose of adjuvant mitotane could be an option for a patient with complete surgical resection in an expectation to prevent microscopic residual disease from recurrence.