Efficacy of Radiofrequency Ablation in the Treatment of Small Functional Adrenal Neoplasms
| Autor: | Olga R. Brook, Robert G. Sheiman, Darren D. Brennan, Salomao Faintuch, Peter Mowschenson, S. Nahum Goldberg, Mishal Mendiratta-Lala |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment Adrenal Gland Neoplasm Treatment outcome Adrenal Gland Neoplasms Thermal ablation Adrenal neoplasm Catheter ablation Radiography Interventional Clinical success law.invention law Biomarkers Tumor medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies business.industry Retrospective cohort study Middle Aged Surgery Treatment Outcome Catheter Ablation Female Radiology business |
| Zdroj: | Radiology. 258:308-316 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.10100690 |
| Popis: | To evaluate the use of radiofrequency (RF) ablation as a primary treatment for symptomatic primary functional adrenal neoplasms and determine the efficacy of treatment with use of clinical and biochemical follow-up.After obtaining institutional review board approval, the authors retrospectively evaluated images and medical records from 13 consecutive patients with symptomatic functional adrenal neoplasms (3.2 cm in diameter) who underwent RF ablation during a 7-year period. There were six men and seven women with a mean age of 54.1 years (range, 42-71 years). Cross-sectional images, findings from clinical examination, and adrenal biochemical markers were available for all patients. Ten of the 13 patients (77%) had an aldosteronoma and one patient each had a cortisol-secreting tumor, testosterone-secreting tumor, and pheochromocytoma. RF ablation was performed by two radiologists using an internally cooled electrode and a pulsed technique according to manufacturer's specifications. Clinical and laboratory follow-up was performed for all patients. Three patients underwent imaging follow-up for other reasons.All patients demonstrated resolution of abnormal biochemical markers after ablation (mean biochemical follow-up, 21.2 months). In addition, all patients experienced resolution of clinical symptoms or syndromes, including hypertension and hypokalemia (in patients with aldosteronoma), Cushing syndrome (in the patient with cortisol-secreting tumor), virilizing symptoms (in the patient with testosterone-secreting tumor), and hypertension (in the patient with pheochromocytoma). For the patients with aldosteronoma, improvements in hypertension management were noted. The mean blood pressure before ablation was 149/90 mm Hg with a mean (±standard deviation) of 3.1 ± 0.6 blood pressure medications, and this decreased to 122/77 mm Hg at a mean of 2.8 months after ablation with 1.3 ± 0.9 medications (P.001) and 124/75 mm Hg at a mean of 41.4 months. There were two minor complications: one small pneumothorax and one limited hemothorax, neither of which required overnight admission. There were two episodes of transient self-remitting procedural hypertension-one in a patient with aldosteronoma and one in the patient with a cortisol-secreting tumor; however, none of these patients required further therapy during overnight observation.RF ablation may be an effective, minimally invasive method for treating small functional primary adrenal tumors. |
| Databáze: | OpenAIRE |
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