J.Jpn. Surg. Soc.. 80(11): 1032-1034, 1979
Report on the annual meeting
ADRENAL AUTOTRANSPLANTATION AFTER TOTAL ADRENALECTOMY
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Second Department of Surgery, Faculty of Medicine, Kyoto University Hiroshi Tanimura |
Total adrenalectomy for Cushing's syndrome due to bilateral adrenal hyperplasia had performed in 21 cases. However, the patients need lifelong cortisol supplement therapy, and one case has suffered from Nelson's syndrome. Since Franksson (1959) had first auto-implanted large pieces of adrenal gland in 5 patients with Cushing's syndrome, only 26 patients with implanted autografts in the tigh had reported until 1978.
In this paper, a 11-year-old girl received total adrenalectomy for bilateral adrenal pheochromocytomas. Small slices, 3 x 3 mm, were obtained from the remained cortex around the left adrenal tumors and 30 fragments were implanted into the abdominal rectus muscle.
Adrenal scintigraphy showed very slight uptake of 131 I-adosteroI in her abdominal wall 2 months after operation. Urinary Ievels of 17 OHCS showed 2.4 to 2.8 mg per day. Although rapid ACTH test did not yet response 1 month later, it showed mild reaction after 1 year. Plasma levels of cortisol reached 24 μg/dl at postoperative 16 months. Her menarche began 5 months after implantation, and the following menstrual function has been regular. She goes to middel school without hormonal replacement, at present time.
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