Simultaneous Bilateral Laparoscopic Adrenalectomy for Adrenocorticotropic Hormone-Independent Macronodular Adrenal Hyerplasia: Report of a Case |
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Authors: | Naoshi Kubo Naoyoshi Onoda Tetsuro Ishikawa Yoshinari Ogawa Tsutomu Takashima Yoshito Yamashita Hideki Tahara Masaaki Inaba Kosei Hirakawa |
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Institution: | (1) Department of Surgical Oncology, Metabolism and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan;(2) Department of Endocrinology, Metabolism and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan |
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Abstract: | Cushing's syndrome caused by adrenocorticotropic hormone (ACTH)-independent macronodular adrenal hyperplasia (AIMAH) is an
extremely rare disease, which shows bilateral macronodular adrenal hypertrophy and autonomous cortisol production. We herein
report a case of AIMAH treated successfully by minimally invasive simultaneous bilateral laparoscopic adrenalectomy. A 73-year-old
woman with hypertension, diabetes mellitus, and osteoporosis was referred to our hospital because of an incidentally found
huge bilateral adrenal mass. An abdominal computed tomography scan showed large bilateral adrenal glands with multiple nodules.
A diagnosis of AIMAH was made and a simultaneous bilateral laparoscopic adrenalectomy was thus performed. The total operation
time was 310 min and blood loss was 70 g. Both glands were hypertrophic (right 5 × 3 cm, 48.5 g and left 4 × 2 cm, 39.2 g)
and consisted of multiple golden yellow macronodules. The postoperative course was uneventful. A simultaneous bilateral adrenalectomy
for AIMAH performed by an experienced surgical team is therefore considered to be a safe and minimally invasive procedure. |
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Keywords: | Adrenocorticotropic hormone-independent macronodular adrenal hyperplasia |
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