Objective: To describe our surgical technique for, and results of, subtotal adrenalectomy for phaeochromocytoma in multiple endocrine neoplasia (MEN) type 2.
Design: Retrospective study.
Setting: Teaching hospital, The Netherlands.
Subjects: 6 patients (four women and 2 men, mean age 35 years, range 31-46) with MEN type 2 who presented between 1993 and 1996.
Interventions: Cortical sparing adrenalectomy (n =4) together with contralateral total adrenalectomy in bilateral disease (n = 2).
Main Outcome Measures: Morbidity, mortality, adrenal function postoperatively, and recurrence.
Results: Cortical sparing adrenalectomy leaving adequate adrenal reserve was possible in all cases. There was no operative morbidity or mortality. Mean follow-up was 40 months (range 1347). One patient developed a recurrent phaeochromocytoma 24 months after subtotal adrenalectomy.
Conclusions: Subtotal adrenalectomy with preservation of adequate adrenal cortical reserve was feasible in all cases. Long term follow-up is necessary to establish its definitive place in the treatment of familial phaeochromocytoma.
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http://dx.doi.org/10.1080/110241599750006415 | DOI Listing |
Curr Opin Oncol
January 2024
Department of General, Visceral and Transplantation Surgery, Division of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany.
Purpose Of Review: Significant advances have transformed our understanding of the molecular biology and natural history of multiple endocrine neoplasia type 2 (MEN2). This progress enacted a paradigm shift with regard to routine neck dissection for medullary thyroid cancer and total adrenalectomy for pheochromoytoma. The purpose of this review is to summarize key molecular and clinical data underpinning the current risk-based approach to MEN2 that integrates molecular and biomarker results.
View Article and Find Full Text PDFBJS Open
November 2023
Endocrine Surgery Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.
Background: Bilateral pheochromocytomas are rare and often heritable. Total adrenalectomy leads to a definitive oncological cure, with subsequent definitive hypocortisolism. Subtotal adrenalectomy is a possible alternative.
View Article and Find Full Text PDFNeuro Endocrinol Lett
September 2023
Department of Endocrinology, Panzhihua Central Hospital, Panzhihua, 617067 China.
Background: Clinically, the incidence of ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is often obscured, making it difficult to identify the primary lesion. This can pose challenges in both diagnosing and treating the disease. Therefore, this paper presents two cases of EAS to share insights and guide diagnosis and treatment approaches.
View Article and Find Full Text PDFCurr Opin Endocrinol Diabetes Obes
June 2023
Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Purpose Of Review: Review the literature on the surgical management of adrenal diseases, highlighting the various surgical approaches and their respective pros and cons.
Recent Findings: Minimally invasive adrenalectomy is commonly used for small and benign adrenal tumors, whereas open adrenalectomy is preferred for larger tumors and primary adrenal malignancy. Although minimally invasive adrenalectomy results in shorter recovery and fewer complications compared with open, the latter offers better oncologic outcomes in the setting of primary adrenal malignancy.
BMC Endocr Disord
April 2023
Department of Urology, Daping Hospital, Army Medical University, 10#, ChangjiangZhilu, Yuzhong District, Chongqing, 400042, People's Republic of China.
Background: Primary bilateral macronodular adrenocortical hyperplasia (PBMAH) is a highly heterogeneous disease with divergent manifestations ranging from asymptomatic subclinical Cushing syndrome (CS) to overt Cushing syndrome with severe complications. ARMC5 mutations occur in 20 to 55% PBMAH patients usually with more severe phenotypes. Different ARMC5 mutations might be associated with diverse phenotypes of PBMAH.
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