Adrenocortical carcinoma with circulating tumor DNA analysis at post-operative recurrence: a case report with review of literature

Recently, the usefulness of circulating tumor DNA (ctDNA) analysis in various malignancies has been reported. However, reports on ctDNA analysis in adrenocortical carcinoma (ACC) are few. Therefore, this study aimed to examine the detectability of genetic mutations in ctDNA and the association betwe...

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Main Authors: Daisuke Aono, Toshiaki Kato, Akina Morisawa, Sakuya Kimata, Seigo Konishi, Mitsuhiro Kometani, Takashi Yoneda, Kazuyoshi Hosomichi, Shigehiro Karashima
Format: Article
Language:English
Published: The Japan Endocrine Society 2025-03-01
Series:Endocrine Journal
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Online Access:https://www.jstage.jst.go.jp/article/endocrj/72/3/72_EJ24-0346/_html/-char/en
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author Daisuke Aono
Toshiaki Kato
Akina Morisawa
Sakuya Kimata
Seigo Konishi
Mitsuhiro Kometani
Takashi Yoneda
Kazuyoshi Hosomichi
Shigehiro Karashima
author_facet Daisuke Aono
Toshiaki Kato
Akina Morisawa
Sakuya Kimata
Seigo Konishi
Mitsuhiro Kometani
Takashi Yoneda
Kazuyoshi Hosomichi
Shigehiro Karashima
author_sort Daisuke Aono
collection DOAJ
description Recently, the usefulness of circulating tumor DNA (ctDNA) analysis in various malignancies has been reported. However, reports on ctDNA analysis in adrenocortical carcinoma (ACC) are few. Therefore, this study aimed to examine the detectability of genetic mutations in ctDNA and the association between ctDNA allelic ratio and disease progression in a patient with post-operative recurrence of ACC. A 77-year-old woman presented with a 5.4 cm left adrenal mass, which was clinically diagnosed as subclinical cortisol-producing ACC on close examination. She underwent left adrenalectomy and was diagnosed with stage II (T2N0M0) ACC. Post-operatively, adjuvant chemotherapy with mitotane was commenced because of histologically high-grade ACC. However, 17 months post-operatively, she had a local recurrence at the left adrenalectomy site. FoundationOne® CDx Cancer Genome Profile showed CTNNB1 G34A mutation in the resected adrenal tumor. She had heart failure and interstitial pneumonia and was treated with radiotherapy for local recurrence. Subsequently, lung and liver metastasis appeared post-operatively at 21 and 23 months, respectively. Serum dehydroepiandrosterone sulfate and computed tomography findings at 27 months post-operatively showed disease progression. We collected the peripheral blood at 23 and 27 months post-operatively and analyzed 18 genes associated with adrenal disease in plasma cell-free DNA and the resected adrenal tumor using a next-generation sequencer. At both time-points, CTNNB1 mutations consistent with the primary tumor were observed in ctDNA, with the allelic ratio increasing over time from 8% to 27%. In conclusion, monitoring the ctDNA allelic ratio may be useful for evaluating disease progression in advanced ACC.
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spelling doaj-art-68aa8a8f6bb244ca9c5fc4eb74df97f52025-08-20T02:54:27ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402025-03-0172332533210.1507/endocrj.EJ24-0346endocrjAdrenocortical carcinoma with circulating tumor DNA analysis at post-operative recurrence: a case report with review of literatureDaisuke Aono0Toshiaki Kato1Akina Morisawa2Sakuya Kimata3Seigo Konishi4Mitsuhiro Kometani5Takashi Yoneda6Kazuyoshi Hosomichi7Shigehiro Karashima8Department of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8641, JapanDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8641, JapanDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8641, JapanDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8641, JapanDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8641, JapanDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8641, JapanDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8641, JapanLaboratory of Computational Genomics, School of Life Science, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, JapanDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Ishikawa 920-8641, JapanRecently, the usefulness of circulating tumor DNA (ctDNA) analysis in various malignancies has been reported. However, reports on ctDNA analysis in adrenocortical carcinoma (ACC) are few. Therefore, this study aimed to examine the detectability of genetic mutations in ctDNA and the association between ctDNA allelic ratio and disease progression in a patient with post-operative recurrence of ACC. A 77-year-old woman presented with a 5.4 cm left adrenal mass, which was clinically diagnosed as subclinical cortisol-producing ACC on close examination. She underwent left adrenalectomy and was diagnosed with stage II (T2N0M0) ACC. Post-operatively, adjuvant chemotherapy with mitotane was commenced because of histologically high-grade ACC. However, 17 months post-operatively, she had a local recurrence at the left adrenalectomy site. FoundationOne® CDx Cancer Genome Profile showed CTNNB1 G34A mutation in the resected adrenal tumor. She had heart failure and interstitial pneumonia and was treated with radiotherapy for local recurrence. Subsequently, lung and liver metastasis appeared post-operatively at 21 and 23 months, respectively. Serum dehydroepiandrosterone sulfate and computed tomography findings at 27 months post-operatively showed disease progression. We collected the peripheral blood at 23 and 27 months post-operatively and analyzed 18 genes associated with adrenal disease in plasma cell-free DNA and the resected adrenal tumor using a next-generation sequencer. At both time-points, CTNNB1 mutations consistent with the primary tumor were observed in ctDNA, with the allelic ratio increasing over time from 8% to 27%. In conclusion, monitoring the ctDNA allelic ratio may be useful for evaluating disease progression in advanced ACC.https://www.jstage.jst.go.jp/article/endocrj/72/3/72_EJ24-0346/_html/-char/enadrenocortical carcinomaadrenal cancercirculating tumor dnanext-generation sequencinggenetic mutations
spellingShingle Daisuke Aono
Toshiaki Kato
Akina Morisawa
Sakuya Kimata
Seigo Konishi
Mitsuhiro Kometani
Takashi Yoneda
Kazuyoshi Hosomichi
Shigehiro Karashima
Adrenocortical carcinoma with circulating tumor DNA analysis at post-operative recurrence: a case report with review of literature
Endocrine Journal
adrenocortical carcinoma
adrenal cancer
circulating tumor dna
next-generation sequencing
genetic mutations
title Adrenocortical carcinoma with circulating tumor DNA analysis at post-operative recurrence: a case report with review of literature
title_full Adrenocortical carcinoma with circulating tumor DNA analysis at post-operative recurrence: a case report with review of literature
title_fullStr Adrenocortical carcinoma with circulating tumor DNA analysis at post-operative recurrence: a case report with review of literature
title_full_unstemmed Adrenocortical carcinoma with circulating tumor DNA analysis at post-operative recurrence: a case report with review of literature
title_short Adrenocortical carcinoma with circulating tumor DNA analysis at post-operative recurrence: a case report with review of literature
title_sort adrenocortical carcinoma with circulating tumor dna analysis at post operative recurrence a case report with review of literature
topic adrenocortical carcinoma
adrenal cancer
circulating tumor dna
next-generation sequencing
genetic mutations
url https://www.jstage.jst.go.jp/article/endocrj/72/3/72_EJ24-0346/_html/-char/en
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