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Adrenal: Malignant Tumours
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=== Management === * '''Multimodal treatment, surgical resection, radiation therapy, and systemic chemotherapy are often necessary''' * '''Systemic chemotherapy''' **'''Mitotane''' ***Oral synthetic derivative of the insecticide dichlorodiphenyltrichloroethane (DDT) ***Mechanism of action: '''inhibits several enzymes of the adrenal cortex including the cholesterol side-chain cleavage enzyme''' (P450scc, CYP11A1), '''11Ξ²-hydroxylase''' (CYP11B1), '''18-hydroxylase''' (aldosterone synthase, CYP11B2), and 3Ξ²-hydroxysteroid dehydrogenase (3Ξ²-HSD) to a lesser extent ***'''Most commonly used chemotherapeutic agent in the treatment of adrenal cortical carcinoma'''
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