ADRENAL SURGICAL APPROACH IN A WOMAN WITH SYNCHRONOUS BILATERAL ADRENAL TUMORS

CLINICAL CASE

  • Simona Elena Albu The Department of Gynecology, The University Emergency Hospital, Bucharest, Romania & The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
  • Mara Cosorte The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania & The Department of Endocrinology, The National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania
  • Cristina Căpățînă The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania & The Department of Endocrinology, The National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania
  • Anda Dumitrașcu The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania & The Department of Radiology, The National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania
  • Adina Ghemigian The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania & The Department of Endocrinology, The National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania
Keywords: bilateral adrenal tumor, adrenalectomy, incidentaloma

Abstract

Bilateral adrenal tumours are very rare and display various endocrine profiles. The unilateral
approach is indicated if a nonsecretor contralateral pattern is suspected in order to avoid adrenal insufficiency.We present a 48-year-old woman with a history of bradimenorrhea at the age of 44.
The gynecological evaluation was negative but two adrenal tumours were found. CT revealed a
right adrenal tumour of 2 cm and a left one of 2.4 cm. Low-normal ACTH and high serum
chromogranin A were confirmed. After one year, the left tumour increased to 4 cm so laparoscopic
transabdominal left adrenalectomy (with 3 trocars) was successfully performed without any
incident. No conversion was required. Neither intraoperative nor postoperative complications
occurred. The patient was hospitalised 5 days and the wounds healed normally. The pathological
report revealed a benign corticoadenoma. The endocrine evaluation after one week showed that
after surgery ACTH de-suppressed to normal and chromogranin A normalised. The right adrenal
tumour was followed-up for another year and the diameters were stationary. The patient was still
hypertensive and she was offered adequate therapy (which we considered essential for high blood pressure). Life-long periodical check-up is necessary.Unilateral adrenalectomy in patients with both side tumours allows an adequate pathological report and avoids unnecessary contralateral surgery if an incidentaloma is revealed, thus allowing the preservation of adrenal function.

Published
2015-07-01
How to Cite
[1]
S. Albu, M. Cosorte, C. Căpățînă, A. Dumitrașcu, and A. Ghemigian, “ADRENAL SURGICAL APPROACH IN A WOMAN WITH SYNCHRONOUS BILATERAL ADRENAL TUMORS”, JSS, vol. 2, no. 3, pp. 132-135, Jul. 2015.
Section
Articles