Retroperitoneal laparoscopic cool-tip radiofrequency ablation of adrenocortical adenoma with Cushing syndrome
To evaluate the feasibility, safety, and therapeutic effects of retroperitoneoscopic-guided cool-tip radiofrequency ablation (RCRFA) used for the treatment of adrenocortical adenoma with Cushing syndrome.
From May 2006 to May 2009, 12 female patients with adrenocortical adenoma and Cushing syndrome underwent RCRFA. Ten tumors were in the left adrenal gland and two tumors were in the right, with a mean tumor size of 2.8+0.5cm (range 2.0 to 3.5). Technical success was defined as disappearance of tumor enhancement on contrast-enhanced computed tomography imaging acquired within 4 week after RCRFA. Clinical success was defined as improvement in serum cortisol and adrenocorticotropic hormone (ACTH) values and symptoms at the end of follow-up.
Tumor enhancement disappeared after initial RCRFA in all patients (technical success rate 100%) one month later. Both the serum cortisol and ACTH levels returned to normal and the symptoms related to Cushing syndrome had disappeared. Every patient was followed up for more than 6 years (mean 85.2±11.2 months). There was no evidence of residual or recurrent lesion postoperatively. All tumors showed involution (1.5+0.6cm) at the end of the study. No major complications occurred related to the procedures.
Using RCRFA for adrenocortical adenoma with Cushing syndrome is a feasible, safe, and promising treatment method in selected patients.