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- Title
ADENOMA GIGANTE DE GLÂNDULA SUPRA-RENAL: ABORDAGEM CIRÚRGICA LAPAROSCÓPICA.
- Authors
DOS ANJOS NETO, ANTONIO MARCOS; PEREIRA CARDIM, HILTON JOSÉ; GONZALES FAVORETO, MARCELO; SALA, WILSON JOSÉ; ANTONIASSE, PÂMELA; GOBBI DE OLIVEIRA, RAQUEL MARINA; DOS ANJOS NETO FILHO, MÁRIO
- Abstract
The cortex of the adrenal gland (A.G.) may be affected by benign or malignant neoplasms. About 60% of A.G. neoplasms are functioning adrenocortical tumors, resulting in endocrine syndromes, whereas virilization is seen in about 20% to 30% of cases. We report a case of benign and functioning tumor, which produces cortisol and androgens hormones, with expressive dimension of left A.G. treated by laparoscopic surgery. Patient MAA, 36, female, had clinical findings compatible with amenorrhea, hirsutism, arterial hypertension and central obesity. The analysis of computed tomography revealed a heterogeneous solid lesion, well defined in topography of the left A.G., with dimensions: 14 x 10 x 10 cm. The endocrine laboratory tests showed elevated levels of dehydroepiandrosterone (DHEA), total testosterone, serum and urinary cortisol. On the other hand, there were significant decreases in levels of estrogen, progesterone and luteinizing hormone. We chose laparoscopic adrenalectomy tansperitoneal with the use of harmonic scalpel. Our approach was effective for the dissection, with the exception of the lateral portion of the tumor mass, due to its large size. Thus, we supplement the procedure with the hand assisted technique, which allowed the complete dislocation of the medial mass, and its lateral dissection. Afterwards, we held the removal of the tumor through an Pfannestiel incision. After the anatomopathological and immunohistochemical examination it was found that the surgical margins were free and the tumor was classified as a cortical adenoma of the A.G. With technological advancement, it has been possible to extend in a safe and effective laparoscopic surgical treatment for larger tumors, as we reported here. Thus, we suggest that the laparoscopic approach is a surgical alternative that depends only on the surgeon's preference and experience.
- Subjects
ADENOMA; TUMORS; LAPAROSCOPIC surgery; ENDOSCOPIC surgery; ADRENAL glands
- Publication
UNINGÁ Review, 2011, Vol 8, Issue 2, p31
- ISSN
2178-2571
- Publication type
Article