Navegando por Palavras-chave "Adrenal adenoma"

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    Cushing's syndrome in pregnancy: an overview
    (Sociedade Brasileira de Endocrinologia e Metabologia, 2007-11-01) Vilar, Lucio; Freitas, Maria da Conceição; Lima, Lúcia Helena C.; Lyra, Ruy; Kater, Claudio Elias [UNIFESP]; Federal University of Pernambuco Hospital das Clínicas Division of Endocrinology and Metabolism; Hospital Getúlio Vargas Pernambuco University Medical School Division of Endocrinology and Metabolism; Universidade Federal de São Paulo (UNIFESP)
    Cushing's syndrome (CS) during pregnancy is a rare condition with fewer than 150 cases reported in the literature. Adrenal adenomas were found to be the commonest cause, followed by Cushing's disease. The gestation dramatically affects the maternal hypothalamic-pituitary-adrenal axis, resulting in increased hepatic production of corticosteroid-binding globulin (CBG), increased levels of serum, salivary and urinary free cortisol, lack of suppression of cortisol levels after dexamethasone administration and placental production of CRH and ACTH. Moreover, a blunted response of ACTH and cortisol to exogenous CRH may also occur. Therefore, the diagnosis of CS during pregnancy is much more difficult. Misdiagnosis of CS is also common, as the syndrome may be easily confused with preeclampsia or gestational diabetes. Because CS during pregnancy is usually associated with severe maternal and fetal complications, its early diagnosis and treatment are critical. Surgery is the treatment of choice for CS in pregnancy, except perhaps in the late third trimester, with medical therapy being a second choice. There does not seem to be a rationale for supportive treatment alone.
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    Percutaneous ablation of functioning adrenal adenoma: a report on 11 cases and a review of the literature
    (Springer, 2013-10-01) Nunes, Thiago Franchi [UNIFESP]; Szejnfeld, Denis [UNIFESP]; Wanderley Xavier, Ana Carolina [UNIFESP]; Kater, Claudio Elias [UNIFESP]; Freire, Fabio [UNIFESP]; Andreoni, Cássio [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Percutaneous ablation of functioning adrenal adenomas has been an alternative to videolaparoscopic treatment. This study aimed to evaluate the feasibility, safety and efficacy of radiofrequency ablation (RFA) in the treatment of functioning adrenal tumors using a computed tomography (CT)-guided percutaneous technique as demonstrated by our experience and the literature.Eleven adult patients (mean age 46 years) with a diagnosis of functioning adrenal adenoma underwent CT-guided RFA between October 2011 and August 2012. All RFA procedures were performed using a needle electrode with a single lateral filament and the RITA(A (R)) 1500X radiofrequency generator. the RFA protocol consisted of two cycles of 5 min each with 1-min interval, with no additional ablation cycles. Contrast-enhanced CT scans were obtained and analyzed for immediate treatment success and possible complications.Maximum tumor dimension ranged from 1.2 to 3.4 cm. the mean procedure time was 74 min, and length of hospital stay ranged from 0.9 to 3.2 days (mean 1.8 days). One patient had residual pneumothorax and one patient had neuritis involving the T10 dermatome. of 11 patients, 10 recovered from their condition. Only one patient remained with hyperaldosteronism, but with reduced anti-hypertensive medication.CT-guided percutaneous RFA was a safe and effective treatment for functioning adrenal adenomas, with short hospital length of stay and low complication rate.