Bilateral Adrenalectomy with Autotransplantation of Adrenocortical Tissue or Unilateral Adrenalectomy: Treatment Options for Pheochromocytomas in Multiple Endocrine Neoplasia Type 2A

Endocrine Journal

TAKAO OBARA¹  MASATOSHI IIHARA¹  YUKIO ITO¹  TAKAHIRO OKAMOTO¹  KENZO HIROSE¹  TOMOYUKI YAMASHITA¹  KIYOMI YAMAZAKI¹  MASAKO KANBE¹ 

[1] Department of Endocrine Surgery, Tokyo Women's Medical College

关键词: Multiple endocrine neoplasia type 2A;    Pheochromocytoma;    Adrenalectomy;    Autotransplantation of adrenocortical tissue;   

DOI  :  10.1507/endocrj.43.169

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(30)Cited-By(17)Surgical strategies for pheochromocytomas in patients with multiple endocrine neoplasia (MEN) type 2 syndrome have been controversial. The purpose of this study is to review the current status of patients with MEN 2 who underwent adrenalectomy with or without adrenal autotransplantation. We studied 15 patients with MEN 2A who underwent adrenal surgery between 1981 and 1992. The follow-up survey included physical examination and biochemical determinations. The median period from initial surgery to follow-up was 54 months (range, 0-145 months). Initial bilateral total adrenalectomy was performed on seven patients, and subtotal adrenalectomy was carried out on two. Among six patients who initially underwent unilateral adrenalectomy, four had remained normotensive (median follow-up, 61 months), whereas the other two patients had to undergo reoperation on the contralateral side because of recurrent symptoms. Two patients were suspected of having had a relapse of the disease after total adrenalectomy. Seven patients underwent adrenal autotransplantation; however, none of them were able to discontinue glucocorticoid replacement therapy. In MEN 2A patients having large pheochromocytomas on only one side, unilateral adrenalectomy can be a suitable alternative to bilateral adrenalectomy in terms of blood pressure control and preservation of adrenocortical function. The attempt to preserve adrenocortical function by autotransplantation is discouraged.

【 授权许可】

Unknown