What is it about?

In 5 patients treated with mitotane in adjuvant setting for adrenal cortical carcinoma, we evaluated the clinical impact of mitotane treatment on thyroid funtion. We analyzed the basal thyroid function index (TSH, FT4, FT3 and FT3/FT4 ratio) and the secretory activity of the thyrotrophic cells, using the TRH test. Results were compared to normal controls and to a central hypothyroid group of age-matched females. Mitotane-treated patients with ACC showed low FT4, normal FT3 and TSH and impaired TSH response to TRH, characteristic of central hypothyroidism.

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Why is it important?

Our findings represent the first demonstration in vivo that patients with ACC treated with mitotane have a condition of secondary hypothyroidism, confirming in vitro data and previous clinical observations.

Perspectives

This finding may have a therapeutic implication for treating these patients with replacement therapy with L-thyroxine.

Dr Damiano Gullo
Garibaldi Hospital Catania

Read the Original

This page is a summary of: Mitotane treatment in patients with adrenocortical cancer causes central hypothyroidism, Clinical Endocrinology, August 2015, Wiley,
DOI: 10.1111/cen.12868.
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