Document Detail


Efficacy of radiofrequency ablation in the treatment of small functional adrenal neoplasms.
MedLine Citation:
PMID:  20980448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the use of radiofrequency (RF) ablation as a primary treatment for symptomatic primary functional adrenal neoplasms and determine the efficacy of treatment with use of clinical and biochemical follow-up.
MATERIALS AND METHODS: After obtaining institutional review board approval, the authors retrospectively evaluated images and medical records from 13 consecutive patients with symptomatic functional adrenal neoplasms (<3.2 cm in diameter) who underwent RF ablation during a 7-year period. There were six men and seven women with a mean age of 54.1 years (range, 42-71 years). Cross-sectional images, findings from clinical examination, and adrenal biochemical markers were available for all patients. Ten of the 13 patients (77%) had an aldosteronoma and one patient each had a cortisol-secreting tumor, testosterone-secreting tumor, and pheochromocytoma. RF ablation was performed by two radiologists using an internally cooled electrode and a pulsed technique according to manufacturer's specifications. Clinical and laboratory follow-up was performed for all patients. Three patients underwent imaging follow-up for other reasons.
RESULTS: All patients demonstrated resolution of abnormal biochemical markers after ablation (mean biochemical follow-up, 21.2 months). In addition, all patients experienced resolution of clinical symptoms or syndromes, including hypertension and hypokalemia (in patients with aldosteronoma), Cushing syndrome (in the patient with cortisol-secreting tumor), virilizing symptoms (in the patient with testosterone-secreting tumor), and hypertension (in the patient with pheochromocytoma). For the patients with aldosteronoma, improvements in hypertension management were noted. The mean blood pressure before ablation was 149/90 mm Hg with a mean (±standard deviation) of 3.1 ± 0.6 blood pressure medications, and this decreased to 122/77 mm Hg at a mean of 2.8 months after ablation with 1.3 ± 0.9 medications (P < .001) and 124/75 mm Hg at a mean of 41.4 months. There were two minor complications: one small pneumothorax and one limited hemothorax, neither of which required overnight admission. There were two episodes of transient self-remitting procedural hypertension-one in a patient with aldosteronoma and one in the patient with a cortisol-secreting tumor; however, none of these patients required further therapy during overnight observation.
CONCLUSION: RF ablation may be an effective, minimally invasive method for treating small functional primary adrenal tumors.
Authors:
Mishal Mendiratta-Lala; Darren D Brennan; Olga R Brook; Salomao Faintuch; Peter M Mowschenson; Robert G Sheiman; S Nahum Goldberg
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Publication Detail:
Type:  Journal Article     Date:  2010-10-27
Journal Detail:
Title:  Radiology     Volume:  258     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  308-16     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2010
Affiliation:
Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA. mishal_lala@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / surgery*
Adult
Aged
Catheter Ablation / methods*
Female
Humans
Male
Middle Aged
Radiography, Interventional
Retrospective Studies
Treatment Outcome
Tumor Markers, Biological / analysis
Chemical
Reg. No./Substance:
0/Tumor Markers, Biological

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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