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CARCINOMA of the adrenal cortex is extremely malignant. The neoplastic and endocrine behavior of the tumor both determine the course of the disease in the patient. 1 Success in producing a remission of both of these manifestations in a patient by use of a combination of chemotherapeutic agents, forms the basis of the present report. In addition, this is the first documentation of Addison's disease resulting from chemotherapy of a hyperfunctioning adrenal carcinoma. Report of Case A 17-year-old woman was first seen in Meadowbrook Hospital in December 1964 because of abdominal pain of several days duration. In May 1963 the patient had rapidly developed Cushing's syndrome. At another hospital the diagnosis was confirmed by urinary steroid determinations. An intravenous pyelogram revealed a large mass above the left kidney but there was no evidence of metastases, and results of liver-function studies were normal. On June 19, 1963, an adrenocortical carcinoma weighing

To the Editor.— In the article "Mitotane Use in Inoperable Adrenal Cortical Carcinoma" (223:1109, 1973), Lubitz et al stated that they knew of no case in which a patient was apparently cured of metastatic adrenal carcinoma. I have a patient who was treated with a combination of fluorouracil and mitotane and has been cured for seven years; as of this writing, she is receiving no chemotherapy and is in excellent health. This patient's response to combination chemotherapy was published as a case report in the Archives of Internal Medicine . 1