Recurrent Cushing's Syndrome after Adrenal Autotransplantation

 

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Abstract

Adrenalectomy with adrenal autotransplantation used to be performed frequently for Cushing's disease in the past because of the limitations of conventional radiological techniques and the lack of adequate neurosurgical techniques. Today, however, bilateral adrenalectomy may be still required for selective patients with Cushing's syndrome when partial hypophysectomy has failed to control hypercortisolism or the source for ectopic ACTH syndrome could not be determined. Here, we report a case of recurrent Cushing's syndrome due to a pituitary adenoma, who was treated with bilateral adrenalectomy and autotransplantation for her Cushing's syndrome. Having determined pituitary adenoma as the cause of recurrent Cushing's syndrome after endocrinological investigations and imaging, we were able to treat the patient with transsphenoidal adenomectomy. We suggest that transsphenoidal resection of the adenoma rather than excision of the autotransplants and adrenal remnants should be the preferred treatment method for recurrent Cushing's disease.

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Correspondence

B. AkinciMD 

Division of Endocrinology and Metabolism

Department of Internal Medicine

Dokuz Eylul University

Inciralti

35340 Izmir

Turkey

Phone: +90/232/412 37 47

Fax: +90/232/279 22 67

Email: baris.akinci@deu.edu.tr