Abstract
Adrenocortical carcinoma (ACC) is a rare disease with an incidence of 1 in 1.7 million. Due to its rare occurrence, there is sparse data on fertility or reproductive outcomes for patients with ACC. Our case demonstrates a nulligravida woman with recurrent metastatic ACC on daily mitotane that was diagnosed with an incidental pregnancy. Mitotane crosses the placenta, but the teratogenic effects are unknown. Currently, there are only five case reports published of women with ACC conceived while on mitotane. We present a case of pregnancy in a woman with metastatic ACC who was treated with mitotane.