Takeuchi Nobuyoshi, Imamura Yusuke, Ishiwata Kazuki, Kanesaka Manato, Goto Yusuke, Sazuka Tomokazu, Suzuki Sawako, Koide Hisashi, Sakamoto Shinichi, Ichikawa Tomohiko
Department of Urology Chiba University Graduate School of Medicine Chiba Japan.
Department of Clinical Cell Biology Chiba University Graduate School of Medicine Chiba Japan.
IJU Case Rep. 2023 Sep 10;6(6):415-418. doi: 10.1002/iju5.12637. eCollection 2023 Nov.
Laparoscopic adrenalectomy is the standard treatment for adrenal tumors caused by Cushing's syndrome. However, few pregnant women have undergone adrenalectomy because of the risk of general anesthesia and surgery.
A 28-year-old woman presented with gradually worsening Cushing's signs at around 12 weeks of pregnancy. Magnetic resonance imaging displayed a 38-mm left adrenal tumor, which was the cause of the adrenal Cushing's syndrome. Metyrapone was started, which increased androgen levels. Since the management of Cushing's syndrome by medication alone is challenging, unilateral laparoscopic adrenalectomy by a retroperitoneal approach was performed at 23 weeks of the pregnancy. No perioperative complications were noted.
Adrenalectomy is considered safe in pregnant women with Cushing's syndrome. Laparoscopic adrenalectomy by retroperitoneal approach should be chosen and performed between 14 and 30 weeks of pregnancy to prevent mother and fetal complications.
腹腔镜肾上腺切除术是库欣综合征所致肾上腺肿瘤的标准治疗方法。然而，由于全身麻醉和手术风险，很少有孕妇接受肾上腺切除术。
一名28岁女性在妊娠约12周时出现库欣体征逐渐加重。磁共振成像显示左侧肾上腺有一个38毫米的肿瘤，这是肾上腺库欣综合征的病因。开始使用甲吡酮治疗，这使雄激素水平升高。由于仅通过药物治疗库欣综合征具有挑战性，因此在妊娠23周时通过腹膜后途径进行了单侧腹腔镜肾上腺切除术。未发现围手术期并发症。
对于患有库欣综合征的孕妇，肾上腺切除术被认为是安全的。应选择在妊娠14至30周之间通过腹膜后途径进行腹腔镜肾上腺切除术，以预防母婴并发症。
