J.Jpn. Surg. Soc.. 57(11): 1801-1828, 1957

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EXPERIMENTAL AND CLINICAL STUDY ON ADRENAL AUTOTRANSPLANTATION INTO THE PORTAL CIRCULATION COMBINED WITH OOPHORECTOMY

Adrenal autotransplantation into the portal circulation combined with oophorectomy, as the endocrinological surgical treatment of advanced breast cancer, has been attempted. The author performed this procedure experimentally in the dog, and then the author have gained some results especially in regards to the change of sexual hormones. Furthermore some clinical results were obtained.
The results are as follows.
Experimental study :
1) When adrenal autotransplantation into the portal circulation (spleen or mesentery of spleen) in the rat was done, the transplanted adrenal showed decreased estrogen activity to increase the uterine weight.
2) After oophorectomy only, a great quantity of estrogen was excreted in urine, but in the group A in which bilateral adrenal autotransplantation into the portal circulation combined with oophorectomy was done, no estrogen was seen to be excreted in urine. When adrenal autotransplantation into the caval circulation (abdominal muscle or renal subcapsular) was done, though very little, was excreted in urine.
3) In the group A, 17-KS in urine markedly decreased just after the procedure. and gradually increased day by day. In the group B in which only bilateral adrenalectomy was done, 17-KS in urine decreased and the dog ended to death finally.
4) In the group A, after administration of ACTH, circulating eosinophils decreased, and 17-KS increased. But in the group B after administration of ACTH, no such reaction was observed.
5) In the group A, after the procedure, a small doses of cortisone and DOCA had to be given (25 mg of cortisone and 0.5 mg of DOCA was injected once in 10 days) to maintain life, in the group B larger doses was necessary and still the dog ended to death in early stage.
6) Transplanted adrenal gland in the dog were alive histologically and in the cortex hyperplasia and regeneration were clearly observed but the medulla completely disappeared.
Clinical study :
1) Clinically, in cases of adrenal autotransplantation into the portal circulation combined with oophorectomy, no estrogen was excreted in urine and 17-KS decreased to the level of the preoperative value. After the operation, 17-KS gradually showed a tendency to increase but estrogen never appeared. After administration of ACTH, 17-KS and 17-HOCS were increased, however estrogen still did not appear.
2) After the operation, subjective and objective symptoms were markedly improved.
3) After the operation, maintenance doses of cortisone were able to be diminished gradually until 6.5-12.5 mg daily.
(author's abstract)

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