Key result
Unilateral adrenalectomy achieves sustained Cushing syndrome remission for ~6 years in isolated PPNAD.
Case Report (n=1)
No
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Reports Cushing syndrome remission after unilateral total adrenalectomy in primary pigmented nodular adrenocortical disease, indicating unilateral resection can achieve disease control.
In October 2001, a 45-year-old man presented to our clinic with a cushingoid appearance. Endocrine studies revealed adrenal-dependent Cushing syndrome. An adrenal scintigram with 131 I-6β-iodomethyl-19-norcholesterol showed uptake of the isotope in the left adrenal gland on the second day and in the right adrenal gland on the fourth day after injection of the tracer. Computed tomography (CT) of the abdomen displayed a nodule (2 cm in diameter) on the left adrenal gland and a normal-appearing right adrenal gland. A laparoscopic left adrenalectomy was performed in November 2001. Primary pigmented nodular adrenocortical disease (PPNAD) was diagnosed pathologically. Cushingoid features persisted after the surgery. A repeat computed tomography of the abdomen demonstrated a residual nodule (1.5 cm in diameter) on the left adrenal gland. The patient then underwent an open left total adrenalectomy in March 2002. Following this procedure, the patient's cushingoid appearance progressively resolved. Cushing syndrome remains in remission some 69 months after unilateral total adrenalectomy.
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Tung et al. (2009) conducted a case report in Cushing syndrome due to primary pigmented nodular adrenocortical disease (PPNAD) (n=1). Open left total adrenalectomy was evaluated on Remission of Cushing syndrome. Unilateral total adrenalectomy achieved sustained remission of Cushing syndrome for 69 months in a 45-year-old man with primary pigmented nodular adrenocortical disease.
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