Unilateral adrenalectomy for the treatment of refractory or recurrent Cushing disease: report of 10 cases
10.3760/cma.j.issn.1000-6702.2013.02.001
- VernacularTitle:肾上腺单侧切除术治疗复杂性库欣病10例报告
- Author:
Dong WANG
;
Hanzhong LI
- Publication Type:Journal Article
- Keywords:
Adrenalectomy;
Cushing disease;
Hypercortisolemia;
Refractory;
Recurrence
- From:
Chinese Journal of Urology
2013;(2):85-88
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the value of unilateral adrenalectomy(UA)for the treatment of refractory or recurrent Cushing disease(RRCD).Methods From January 2003 to July 2011,10 patients with RRCD underwent UA.The preoperative symptoms,preoperative treatments,intra-and post-operative complications and follow-up in patients were reviewed.All the 10 patients presented with hypercortisolemia symptoms.Transsphenoidal surgery had been performed in 9 patients as initial therapy.Of the 10 patients,8 received radiation therapy before adrenalectomy.All the 10 cases accepted a right UA.Results No perioperative complications occurred.The 10 patients were followed up for 1-8 years.Eight patients with radiation therapy before adrenalectomy got remission.Two bilateral adrenalectomies were eventually performed because the symptoms could not be controlled.Of the 8 patients who got remission,none of them developed Nelson syndrome and none need lifelong mineralocorticoid and glucocorticoid replacement therapy.Conclusions UA could be an option for RRCD.For patients with RRCD receiving radiation therapy,UA may effectively relief hypercortisolemia.Compared with bilateral adrenalectomies,UA could avert permanent adrenal insufficiency,which leads to a lifelong glucocorticoid and mineralocorticoid replacement therapies,and a life-threatening adrenal crisis.
