Diabetes, Metabolic Syndrome and Obesity (Oct 2020)

Adrenal Artery Ablation for the Treatment of Hypercortisolism Based on Adrenal Venous Sampling: A Potential Therapeutic Strategy

  • Zhou Q,
  • Liu X,
  • Zhang H,
  • Zhao Z,
  • Li Q,
  • He H,
  • Zhu Z,
  • Yan Z

Journal volume & issue
Vol. Volume 13
pp. 3519 – 3525

Abstract

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Qing Zhou, Xiaoli Liu, Hexuan Zhang, Zhigang Zhao, Qiang Li, Hongbo He, Zhiming Zhu, Zhencheng Yan Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Daping Hospital and the Research Institute of Surgery, Army Medical University, Chongqing 400042, People’s Republic of ChinaCorrespondence: Zhencheng YanDepartment of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Daping Hospital and the Research Institute of Surgery, Army Medical University, Chongqing 400042, People’s Republic of ChinaTel +86-23-68757883Email [email protected]: Hypercortisolism is characterized by metabolic disorders and high mortality rates. Adrenalectomy and medical therapies are considered major treatment options. However, some patients, especially young patients, are strongly against undergoing surgery in case of secondary hypocortisolism or relapses that require replacement supplements or pharmacological interventions. In such cases, alternative therapies are needed to treat hypercortisolism.Methods: We report a 27-year-old Chinese female with adrenal cortisol-producing adenoma. The patient’s circadian rhythm and concentrations of cortisol were abnormal, accompanying with an increased 24-hour urinary cortisol level. Computed tomography (CT) revealed a nodular soft-tissue mass in the right adrenal gland.Results: Cortisol hypersecretion from the right adrenal gland was verified by adrenal venous sampling (AVS). Adrenal artery ablation was performed. After ablation, long-term follow-up showed that the patient’s symptoms subsided and abnormal laboratory test results returned to normal without pharmacological treatment.Conclusion: AVS might be a promising method to aid the diagnosis of cortisol-producing adenoma. Adrenal artery ablation is minimally invasive and may be useful for the treatment of adrenal adenoma or nodular diseases, especially in patients who cannot undergo surgery.Keywords: adrenal cortisol adenoma, adrenal artery ablation, adrenal venous sampling, Cushing’s syndrome

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