腹腔鏡下両側副腎摘除術を施行したACTH非依存性両側副腎皮質大結節性過形成の1例

Abstract

62歳男.標記摘除術を一期的に施行し良好な結果を得た.手術は先ず右側臥位で経腹的側方到達法により左副腎摘除術を行い, 次に左側臥位で経腹的前方到達法により右副腎摘除術を施行した.本術式は安全に施行可能であり, 今後考慮されるべき選択肢の一つと思われた

We report a case of ACTH-independent macronodular adrenal hyperplasia (AIMAH). A 62-year-old man was admitted to our hospital for further examination of obesity and diabetes mellitus. He was diagnosed with Cushing's syndrome by endocrinological examinations, and computed tomography and magnetic resonance imaging findings revealed nodular hyperplasia in bilateral adrenal glands, suggesting its etiology to be AIMAH. We underwent simultaneous bilateral laparoscopic adrenalectomy. A preoperative diagnosis of AIMAH was confirmed by histological examination of both adrenal glands, weighing 21 g (right) and 16 g (left). The postoperative course was uneventful. We believe that simultaneous bilateral laparoscopic adrenalectomy is feasible, safe, and results in minimal postoperative morbidity for the treatment of AIMAH.