Adrenalectomy for adrenocortical adenoma causing Cushing's syndrome in pregnancy: a case report and review of literature
| Autor: | Rami N. Sammour, Max Cohen, Carmela Shechner, Gonen Ohel, Leonard Saiegh, Ibrahim Matter, Ron Gonen, Gabriel Dickstein |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
medicine.medical_specialty Pediatrics Hydrocortisone Hormone Replacement Therapy Term Birth medicine.medical_treatment Pregnancy Trimester Third Intrauterine growth restriction Adrenocorticotropic hormone Adrenocortical adenoma Pregnancy medicine Humans Laparoscopy Cushing Syndrome medicine.diagnostic_test business.industry Adrenalectomy Obstetrics and Gynecology Gestational age medicine.disease Adrenal Cortex Neoplasms Surgery Diabetes Gestational Treatment Outcome Reproductive Medicine Adrenocortical Adenoma Female business Pregnancy Complications Neoplastic Medical literature |
| Zdroj: | European journal of obstetrics, gynecology, and reproductive biology. 165(1) |
| ISSN: | 1872-7654 |
| Popis: | We present a case of adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome diagnosed in a patient in the third trimester of her pregnancy, with an adrenal mass observed on imaging studies. Laparoscopic adrenalectomy was performed successfully at 32 weeks. To the best of our knowledge, this is the latest gestational age at which laparoscopic adrenalectomy has been reported. We present the various considerations for determining the surgical approach and the optimal timing for surgery. Adrenalectomy during pregnancy for the treatment of Cushing's syndrome caused by adrenocortical adenoma has been reported in 23 patients in the English-language medical literature to date and seems safe and beneficial. According to the data, surgical treatment has led to a reduction in perinatal mortality and maternal morbidity rates, but has not affected the occurrence of preterm birth and intrauterine growth restriction. The best outcome can be achieved by a multidisciplinary approach, with a team comprising a maternal–fetal medicine specialist, an endocrinologist and a surgeon. The timing of surgery and the surgical approach need to be determined according to the surgeon's expertise, the severity of the condition, the patient's preferences, and gestational age. Laparoscopy may prove to be the preferred surgical approach. The small number of cases precludes providing evidence-based recommendations. |
| Databáze: | OpenAIRE |
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