As a conclusion, a genetic analysis is suggested in all pediatric pheochromocytomas regardless of family history and cortical sparing
adrenalectomy should be the choice of preference in bilateral cases.
In eight patients, an
adrenalectomy was performed, one patient with bilateral adrenal metastasis was treated with afterloading, and one metastasis remained untreated due to severe tumor progress and reduced physical condition of the patient.
Pisarska et al., "Laparoscopic transperitoneal
adrenalectomy in morbidly obese patients is not associated with worse short-term outcomes," International Journal of Urology, vol.
The patient was transferred to a facility with cardiothoracic surgical support capabilities including left ventricular-assisted device and cardiac transplant prior to the planned
adrenalectomy. Surgery was completed successfully with balloon pump backup and with histology results confirming the diagnosis of pheochromocytoma.
A subsequent left radical nephrectomy and
adrenalectomy was performed.
Whether open or laparoscopic, there are two surgical treatment approaches: radical (pericystectomy and en bloc
adrenalectomy with cystectomy) and conservative (partial cystectomy).
In all groups, 66.6% CS patients underwent surgical treatment (67 (61.5%) patients with ACTH-independent syndrome underwent laparoscopic
adrenalectomy and 42 (38.5%) patients with ACTH-dependent disease underwent transsphenoidal hypophyseal microneurosurgery), showing complete remission of cortisol excess based on the normalization of biochemical and clinical features during follow-up.
(2) Long-term medical therapy for CS is ineffective and definitive therapy is the resection of pituitary or adrenal adenoma or bilateral
adrenalectomy for hyperplasia.
The surgery and endocrinology teams were consulted, and the patient underwent bilateral
adrenalectomy. Surgery seemed to be the best option to lessen the risk of malignancy, prevent retroperitoneal haemorrhage, alleviate the pain symptoms, and decrease opiod dependence.
A total of 41 patients underwent
adrenalectomy during this period.
There is evidence for basal regulation of GR expression because
adrenalectomy increases GR mRNA and protein in the hippocampus [22].
The patient elected to proceed with robotic assisted left radical
adrenalectomy. Preoperatively patient was placed on alpha blockade with phenoxybenzamine.
We report a 61 year old male with solitary right adrenal metastasis 15 months post LT which was managed with open
adrenalectomy. The patient is alive and disease free 24 months after the surgery.