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[LAPAROSCOPIC BILATERAL ADRENALECTOMY FOR REFRACTORY CUSHING DISEASE: A CASE REPORT]
Yohei Yamanaka1, Atsunari Kawashima1, Yujiro Hayashi1
1Department of Urology, Osaka University Graduate School of Medicine.
Cushing's disease is a complex endocrine disorder. Laparoscopic bilateral adrenalectomy offered a solution for a patient with persistent high cortisol levels and complications like deep vein thrombosis.
Area of Science:
- Endocrinology
- Surgical Oncology
Context:
- A 64-year-old male patient presented with Cushing's disease, initially diagnosed in 2009.
- The patient experienced multiple lumbar compression fractures as a consequence of the disease.
Purpose:
- To explore treatment outcomes for refractory Cushing's disease.
- To evaluate the efficacy of laparoscopic bilateral adrenalectomy in managing severe, treatment-resistant Cushing's disease.
Summary:
- Despite multiple transsphenoidal surgeries and radiotherapy, the patient's serum cortisol levels remained elevated.
- Complications included intractable cutaneous ulcers, severe hepatic dysfunction, deep vein thrombosis, and pulmonary artery embolism.
- Laparoscopic bilateral adrenalectomy was performed as a definitive treatment to control the disease.
Impact:
- Highlights the challenges in managing treatment-resistant Cushing's disease.
- Demonstrates the potential of adrenalectomy in achieving disease control when other therapies fail.
- Underscores the critical need for multidisciplinary management of complex endocrine disorders and their complications.
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