Kubo Naoshi, Onoda Naoyoshi, Ishikawa Tetsuro, Ogawa Yoshinari, Takashima Tsutomu, Yamashita Yoshito, Tahara Hideki, Inaba Masaaki, Hirakawa Kosei
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Osaka, Japan.
Surg Today. 2006;36(7):642-6. doi: 10.1007/s00595-006-3209-6.
Cushing's syndrome caused by adrenocorticotropic hormone (ACTH)-independent macronodular adrenal hyperplasia (AIMAH) is an extremely rare disease, which shows bilateral macronodular adrenal hypertrophy and autonomous cortisol production. We herein report a case of AIMAH treated successfully by minimally invasive simultaneous bilateral laparoscopic adrenalectomy. A 73-year-old woman with hypertension, diabetes mellitus, and osteoporosis was referred to our hospital because of an incidentally found huge bilateral adrenal mass. An abdominal computed tomography scan showed large bilateral adrenal glands with multiple nodules. A diagnosis of AIMAH was made and a simultaneous bilateral laparoscopic adrenalectomy was thus performed. The total operation time was 310 min and blood loss was 70 g. Both glands were hypertrophic (right 5 x 3 cm, 48.5 g and left 4 x 2 cm, 39.2 g) and consisted of multiple golden yellow macronodules. The postoperative course was uneventful. A simultaneous bilateral adrenalectomy for AIMAH performed by an experienced surgical team is therefore considered to be a safe and minimally invasive procedure.
由促肾上腺皮质激素（ACTH）非依赖性大结节性肾上腺增生（AIMAH）引起的库欣综合征是一种极为罕见的疾病，表现为双侧肾上腺大结节性肥大及自主性皮质醇分泌。我们在此报告一例通过微创同期双侧腹腔镜肾上腺切除术成功治疗的AIMAH病例。一名患有高血压、糖尿病和骨质疏松症的73岁女性因偶然发现双侧肾上腺巨大肿块而转诊至我院。腹部计算机断层扫描显示双侧肾上腺肿大，有多个结节。诊断为AIMAH，遂行同期双侧腹腔镜肾上腺切除术。总手术时间为310分钟，失血量为70克。双侧肾上腺均肥大（右侧5×3厘米，48.5克；左侧4×2厘米，39.2克），由多个金黄色大结节组成。术后过程顺利。因此，由经验丰富的手术团队进行的同期双侧肾上腺切除术治疗AIMAH被认为是一种安全且微创的手术。
