Treatment of Adrenocortical Carcinoma Diagnosed During Pregnancy

When an adrenal mass suspected to be adrenocortical carcinoma (ACC) is identified during pregnancy, the clinical situation demands prompt, structured decision-making that accounts for both oncological urgency and the patient's pregnancy status.

Clinical scenario An adrenal mass suspected to be adrenocortical carcinoma is diagnosed in a pregnant patient. The trimester of pregnancy does not defer the need for timely intervention, and certain systemic treatment options used in ACC carry specific restrictions in this context.

Approach overview

Surgical resection of the adrenal tumour is the cornerstone of management in this setting. Systemic pharmacological options that may otherwise be considered in ACC have important limitations during pregnancy — the full protocol specifies which are contraindicated and how the treatment pathway is structured around this.

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References

When an adrenal mass suspected to be an ACC is diagnosed during pregnancy, we recommend prompt surgical resection regardless of pregnancy trimester.

We recommend avoiding pregnancy while being on mitotane treatment.

DOI: 10.1530/EJE-18-0608

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