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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...

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Autores principales: Mbouché, L.O., Epoupa Ngallé, F.G., Sando, Z., Choukem, S.P., Angwafo, F.F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
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.
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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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