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Subtotal adrenalectomy for phaeochromocytoma in multiple endocrine neoplasia type 2A
J S de Graaf1, C J Lips, J E Rütter
1Department of Surgery, University Hospital Utrecht, The Netherlands.
Objective:
To describe our surgical technique for, and results of, subtotal adrenalectomy for phaeochromocytoma in multiple endocrine neoplasia (MEN) type 2.
Design:
Retrospective study.
Setting:
Teaching hospital, The Netherlands.
Subjects:
6 patients (four women and 2 men, mean age 35 years, range 31-46) with MEN type 2 who presented between 1993 and 1996.
Interventions:
Cortical sparing adrenalectomy (n =4) together with contralateral total adrenalectomy in bilateral disease (n = 2).
Main Outcome Measures:
Morbidity, mortality, adrenal function postoperatively, and recurrence.
Results:
Cortical sparing adrenalectomy leaving adequate adrenal reserve was possible in all cases. There was no operative morbidity or mortality. Mean follow-up was 40 months (range 1347). One patient developed a recurrent phaeochromocytoma 24 months after subtotal adrenalectomy.
Conclusions:
Subtotal adrenalectomy with preservation of adequate adrenal cortical reserve was feasible in all cases. Long term follow-up is necessary to establish its definitive place in the treatment of familial phaeochromocytoma.