A New Insight into the Surgical Treatment of Primary Macronodular Adrenal Hyperplasia

Author(s):Show less -

Tanno, Fabio Yoshiaki ^[1] ; Srougi, Victor ^[1] ; Almeida, Madson Q. ^[2] ; Yamauchi, Fernando Ide ^[3] ; Almeida Coelho, Fernando Morbeck ^[3] ; Nishi, Mirian Yumie ^[1] ; Nogueira Zerbini, Maria Claudia ^[4] ; Correa Soares, Iracy Silvia ^[5] ; Albergaria Pereira, Maria Adelaide ^[2] ; Silva Charchar, Helaine Laiz ^[2] ; Ferreira Lacombe, Amanda Meneses ^[2] ; Brondani, Vania Balderrama ^[2] ; Srougi, Miguel ^[1] ; Nahas, Willian Carlos ^[1] ; Mendonca, Berenice B. ^[2] ; Chambo, Jose Luis ^[1] ; Barisson Villares Fragoso, Maria Candida ^[2]

Affiliation

^[1] Univ Sao Paulo, Hosp Clin, Div Urol, Fac Med, Av Doutor Eneas Carvalho Aguiar 255, 7 Andar, BR-05403900 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Med, Hosp Clin, Serv Endocrinol & Metabol, Unidade Suprarrenal, Lab Hormonios & Genetv Mol LI, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Hosp Clin, Inst Radiol INRAD, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Fac Med, Div Anat Patol, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Fac Med, Hosp Clin, Serv Anestesiol, Sao Paulo - Brazil

• Document type: Journal article
• Source: JOURNAL OF THE ENDOCRINE SOCIETY; v. 4, n. 8 AUG 2020.
• Web of Science Citations: 0

Abstract

Purpose: This prospective study presents the results of a new approach in the treatment of primary macronodular adrenal hyperplasia (PMAII), with simultaneous total adrenalectomy of the larger adrenal gland and partial adrenalectomy of the contralateral adrenal gland (adrenal-sparing surgery). Materials and Methods: We performed a prospective study including 17 patients with PMAH treated surgically with adrenal-sparing surgery in a tertiary referral hospital, with a median follow-up of 41 months. Clinical, hormonal, and genetic parameters were evaluated before surgery and during follow-up. All patients had at least 1 radiological examination before and after the procedure. Results: Among the 17 patients, all but 1 patient had complete hypercortisolism control, and 12 recovered normal adrenal function after surgery. Significant improvement in clinical parameters was observed: weight loss (P = .004); reduction of both systolic (P = .001) and diastolic (P = .001) blood pressure; and reduction in the number of antihypertensive drugs (P < .001). Intra-, peri-, and postoperative complications were not observed. Conclusion: Adrenal-sparing surgery is a safe and feasible procedure to treat patients with PMAH, providing a substantial chance of hypercortisolism control without the disadvantages of lifetime corticosteroid replacement. (C) Endocrine Society 2020. (AU)

• FAPESP's process: 15/50192-9 - Advances in the understanding of the pathophysiology of primary adrenocortical hyperplasia macronodular - PMAH (GP-PMAH)
• Grantee: Maria Candida Barisson Villares Fragoso
• Support Opportunities: Research Projects - Thematic Grants