Amino-Glutethimide and Metastatic Adrenal Cancer

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Abstract
Several compounds have been reported to effectively inhibit hormone production and neoplastic growth in patients with Cushing's syndrome due to metastatic adrenocortical carcinoma.1The most effective of these compounds has been orthopara-prime DDD (o, p', DDD), but the severe side effects which are often encountered has limited its usefulness, particularly for long-term therapy. We have observed a most dramatic and symptomless suppression, of six months' duration, of the excessive cortisol secretion of a patient with metastatic adrenocortical carcinoma. This was brought about by daily administration of a newly discovered inhibitor of steroidal biosynthesis, amino-glutethimide (Elipten, formerly marketed as an anticonvulsive agent). This report details these observations and compares the clinical and biochemical responses in the same patient ofo, p', DDD and amino-glutethimide. Methods Urinary 17-hydroxycorticosteroids (170HCS) were determined by the method of Porter and Silber2; urinary 17-ketosteroids (17KS) by the method of Drekter3; plasma 170HCS by

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