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The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon
INTRODUCTION: Adrenal tumors are often found incidentally during abdominal imaging. Functioning adrenal tumors are less frequent than these incidentalomas discovered unexpectedly. We report treatment outcomes (major complications) of 7 cases of symptomatic adrenal masses from 2009 to 2019. PRESENTAT...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327872/ https://www.ncbi.nlm.nih.gov/pubmed/32698292 http://dx.doi.org/10.1016/j.ijscr.2020.05.097 |
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author | Mbouché, L.O. Epoupa Ngallé, F.G. Sando, Z. Choukem, S.P. Angwafo, F.F. |
author_facet | Mbouché, L.O. Epoupa Ngallé, F.G. Sando, Z. Choukem, S.P. Angwafo, F.F. |
author_sort | Mbouché, L.O. |
collection | PubMed |
description | INTRODUCTION: Adrenal tumors are often found incidentally during abdominal imaging. Functioning adrenal tumors are less frequent than these incidentalomas discovered unexpectedly. We report treatment outcomes (major complications) of 7 cases of symptomatic adrenal masses from 2009 to 2019. PRESENTATION OF THE CASES: Seven cases of functioning adrenal tumors: four adenomas presenting with Cushing’s syndrome, two adrenal carcinomas, and one pheochromocytoma are described. The preoperative diagnoses were made through clinical manifestations, an increase in urinary free cortisol with normal ACTH, elevated metanephrine and enlarged masses on CT. The diagnoses were established on histopathology of adrenalectomy specimens. Adrenal insufficiency in two patients following surgery was corrected with corticoid replacement therapy. One patient died of hypovolemia the day of surgery and another from anaphylactic shock (allergy) late in the post-operative period. DISCUSSION: Pre, intra and post-operative complications from vascular instability often complicate surgery in functioning adrenal tumors. Adrenal adenomas manifest as Cushing’s syndrome in 10–15 % of patients. They are the most common adrenal tumor although the diagnosis is most often coincidental to abdominal imaging. The incidence of adrenal adenoma increases with age, up to 7 % in the seventh decade. Laparoscopic adrenalectomy, which was not available in our hospitals then, is standard treatment for most tumors. It is alleged to have better outcomes in trained and tested hands. CONCLUSION: Surgery of functioning adrenal tumors demands close collaboration of multiple clinical disciplines to manage vascular instability and adrenal insufficiency, especially in resource strapped communities. |
format | Online Article Text |
id | pubmed-7327872 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-73278722020-07-06 The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon Mbouché, L.O. Epoupa Ngallé, F.G. Sando, Z. Choukem, S.P. Angwafo, F.F. Int J Surg Case Rep Article INTRODUCTION: Adrenal tumors are often found incidentally during abdominal imaging. Functioning adrenal tumors are less frequent than these incidentalomas discovered unexpectedly. We report treatment outcomes (major complications) of 7 cases of symptomatic adrenal masses from 2009 to 2019. PRESENTATION OF THE CASES: Seven cases of functioning adrenal tumors: four adenomas presenting with Cushing’s syndrome, two adrenal carcinomas, and one pheochromocytoma are described. The preoperative diagnoses were made through clinical manifestations, an increase in urinary free cortisol with normal ACTH, elevated metanephrine and enlarged masses on CT. The diagnoses were established on histopathology of adrenalectomy specimens. Adrenal insufficiency in two patients following surgery was corrected with corticoid replacement therapy. One patient died of hypovolemia the day of surgery and another from anaphylactic shock (allergy) late in the post-operative period. DISCUSSION: Pre, intra and post-operative complications from vascular instability often complicate surgery in functioning adrenal tumors. Adrenal adenomas manifest as Cushing’s syndrome in 10–15 % of patients. They are the most common adrenal tumor although the diagnosis is most often coincidental to abdominal imaging. The incidence of adrenal adenoma increases with age, up to 7 % in the seventh decade. Laparoscopic adrenalectomy, which was not available in our hospitals then, is standard treatment for most tumors. It is alleged to have better outcomes in trained and tested hands. CONCLUSION: Surgery of functioning adrenal tumors demands close collaboration of multiple clinical disciplines to manage vascular instability and adrenal insufficiency, especially in resource strapped communities. Elsevier 2020-06-15 /pmc/articles/PMC7327872/ /pubmed/32698292 http://dx.doi.org/10.1016/j.ijscr.2020.05.097 Text en © 2020 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Mbouché, L.O. Epoupa Ngallé, F.G. Sando, Z. Choukem, S.P. Angwafo, F.F. The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon |
title | The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon |
title_full | The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon |
title_fullStr | The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon |
title_full_unstemmed | The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon |
title_short | The case series of functional adrenal tumors: Experience of two tertiary hospitals in Yaoundé, Cameroon |
title_sort | case series of functional adrenal tumors: experience of two tertiary hospitals in yaoundé, cameroon |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327872/ https://www.ncbi.nlm.nih.gov/pubmed/32698292 http://dx.doi.org/10.1016/j.ijscr.2020.05.097 |
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