Cushing's syndrome is frequently due to tumors on BOTH adrenal glands. Here's what to do. скачать в хорошем качестве

Cushing's syndrome is frequently due to tumors on BOTH adrenal glands. Here's what to do.

Adrenal Cushing’s syndrome means too much cortisol that originates from the adrenal gland. This is either from one adrenal tumor or from both adrenal glands, called bilateral adrenal Cushing’s syndrome. Sometimes the doctors do it all correctly and diagnose adrenal Cushing’s syndrome but then when they get the CT scan (or MRI) and there are tumors on both adrenal glands (as opposed to just one tumor), people get confused. Many surgeons would only remove one adrenal gland. This does provide some benefit for the patient, but it is not nearly as good as addressing both adrenal tumors through partial adrenalectomy. The Cushing’s syndrome is only completely cured if both tumors are removed. Today's patient is a 71-year-old lady who has struggled with adrenal Cushing’s syndrome for quite some time. She has signs of symptoms of heartburn, excessive hair loss, high blood pressure (hypertension) and diabetes. Her laboratory test showed a Low Dose Dexamethasone Suppression Test that was abnormal (meaning Cortisol in the morning over 1.8). Her ACTH (pituitary hormone) was completely suppressed and her 24 hour urine free (UFC) cortisol was on the high side. She then underwent a CT scan that showed a large mass on the left adrenal gland measuring 6.8 cm, but she also has a 1.4 cm mass on the right adrenal. As I mentioned the best option is to address both adrenal tumors. This can be done in a few different ways but for this patient the best option was to deal with the large left adrenal mass first. She underwent a 21-minute Mini Back Scope Adrenalectomy (MBSA) on the left side. Then in six weeks we will go back and remove the tumor on the right adrenal gland. Both sides can have a partial adrenalectomy (cortex sparing) approach and spacing the operation out for six weeks allow her not to have to be dependent on any steroid hormones, prednisone, or hydrocortisone, whatsoever. This is great news for the patient, and everybody involved. 00:02 Adrenal Cushing syndrome overview 00:39 Partial adrenalectomy approach and plan