Percutaneous Bilateral Adrenal Radiofrequency Ablation in Severe Adrenocorticotropic Hormone-dependent Cushing Syndrome
| العنوان: | Percutaneous Bilateral Adrenal Radiofrequency Ablation in Severe Adrenocorticotropic Hormone-dependent Cushing Syndrome |
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| المؤلفون: | Maciej Otto, Dariusz Konecki, Grzegorz Rosiak, Wojciech Zgliczyński, Olgierd Rowiński, Krzysztof Milczarek |
| المصدر: | Journal of Clinical Imaging Science |
| بيانات النشر: | Scientific Scholar, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | medicine.medical_specialty, Percutaneous, Radiofrequency ablation, medicine.medical_treatment, Adrenocorticotropic hormone, Inferior vena cava, Adrenal ablation, 030218 nuclear medicine & medical imaging, law.invention, 03 medical and health sciences, chemistry.chemical_compound, Cushing syndrome, 0302 clinical medicine, Dehydroepiandrosterone sulfate, law, Interventional Radiology, medicine, Radiology, Nuclear Medicine and imaging, Original Research, business.industry, Adrenalectomy, Cushing disease, medicine.disease, Cushing Disease, Surgery, chemistry, medicine.vein, 030220 oncology & carcinogenesis, business |
| الوصف: | Objectives: The objectives of the study were to evaluate adrenal radiofrequency ablation (RFA) as a method of treatment in patients with severe adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome, among whom bilateral adrenalectomy is not a suitable option. Material and Methods: Five patients with ACTH-dependent Cushing syndrome underwent RFA of both adrenal glands. Four of them presented with Cushing disease unsuccessfully treated with pituitary surgery and medical therapy, while one patient had ACTH-dependent Cushing syndrome due to pancreatic endocrine tumor with liver metastases. All patients were disqualified from adrenalectomy due to morbid obesity or lack of consent. Results: A technical success was obtained in all cases, with only one re-intervention necessitated by a cooling effect of the inferior vena cava. Despite pre-procedural adrenergic blockade, severe hypertension was noted during the procedure in three cases, this being treated immediately using direct-acting vasodilators. No complications occurred otherwise. In all cases, significant improvement of clinical symptoms was observed, as well as marked decreases in levels of serum cortisol, free urine cortisol, and dehydroepiandrosterone sulfate. Conclusion: Bilateral RFA under CT-guidance is technically feasible and clinical improvement can be achieved using the method. In patients disqualified from adrenal surgery, RFA might be considered as an alternative method of ACTH-dependent Cushing syndrome treatment. |
| اللغة: | English |
| تدمد: | 2156-5597 2156-7514 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a6a85ac35b79f3a7203a7df247ecd936Test http://europepmc.org/articles/PMC7568099Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....a6a85ac35b79f3a7203a7df247ecd936 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21565597 21567514 |
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