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April 6, 2026JCA advances.Open Access

Anesthetic management of bilateral adrenal microwave ablation for ectopic Cushing's syndrome in a critically ill patient: A case report

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Authors

HSHallie StevensRGRicardo M. GarciaEWElisabeth Ward

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Overview

Case report demonstrates effective management of ectopic Cushing's syndrome via microwave ablation in a critically ill patient, highlighting its implications for high-risk cases.

Key Points

  • The aim was to outline the anesthetic management and outcomes of bilateral adrenal microwave ablation for ectopic Cushing's syndrome in a critically ill patient.
  • Examined a patient with ACTH-dependent Cushing's syndrome due to neuroendocrine cell hyperplasia.
  • Utilized intravenous etomidate infusion and ketoconazole to manage hypercortisolemia.
  • Performed CT-guided bilateral adrenal microwave ablation under general anesthesia.
  • Administered nicardipine to manage hypertensive crises during the procedure.
  • Provided anticipatory stress-dose glucocorticoids to prevent adrenal insufficiency.
  • Cortisol levels dropped significantly following the microwave ablation procedure.
  • Effective management of hypertensive crises was achieved with nicardipine.
  • The case supports microwave ablation as a viable option in patients with limited surgical candidacy.

Cite This Study

Stevens et al. (2026) studied this question.

synapsesocial.com/papers/69d34d5c9c07852e0af97547https://doi.org/10.1016/j.jcadva.2026.100227
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Bilateral Adrenal Ablation for the Treatment of Ectopic <scp>ACTH</scp> Syndrome With Severe Hypokalemia: A Case Report and a Literature Review2025
  2. 27117 Cushings Conundrum: Taming The Hormone Hurricane2024
  3. 3Efficiency of Microwave Ablation for Cortisol-Producing Adrenal Adenomas: Case Series and a Literature Review2025
  4. 47162 Cushing’s Syndrome due to Metastatic Atypical Pulmonary Carcinoid and the Therapeutic Journey to Bilateral Adrenalectomy2024
  5. 57162 Cushing’s Syndrome Due To Metastatic Atypical Pulmonary Carcinoid And The Therapeutic Journey To Bilateral Adrenalectomy2024