Our Summary

This research paper describes a case of a young woman with a massive tumor in her adrenal gland, referred to as a ‘giant pheochromocytoma’. Her symptoms included heart problems and a noticeable lump in her stomach. The doctors used a technique called transperitoneal laparoscopic right adrenalectomy to remove the tumor. This method is less invasive than traditional surgery, using small incisions and a camera to guide the procedure.

The size of the tumor (13 cm) is usually considered too large for this type of surgery, but the doctors in this case were able to successfully carry out the procedure with excellent results, including a quick recovery and minimal scarring. This suggests that size should not be an absolute barrier to using this technique, at least when performed by experienced surgeons.

The paper concludes that this case could help to inform future guidelines on the use of laparoscopic surgery for removing adrenal tumors. It could also provide useful information for surgeons about the key steps in the procedure.

FAQs

  1. What is a ‘giant pheochromocytoma’?
  2. How is transperitoneal laparoscopic right adrenalectomy performed?
  3. Can large adrenal tumors always be removed using laparoscopic surgery?

Doctor’s Tip

A doctor might tell a patient undergoing adrenalectomy to follow their post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and avoiding strenuous activities. They might also advise the patient to watch for signs of infection or complications, such as fever, swelling, or increased pain, and to contact their healthcare provider if they experience any concerning symptoms. Additionally, the doctor may recommend maintaining a healthy lifestyle, including regular exercise and a balanced diet, to support recovery and overall health.

Suitable For

Patients who are typically recommended adrenalectomy include those with adrenal tumors, such as pheochromocytomas, aldosteronomas, cortisol-producing adenomas, and adrenal metastases. Adrenalectomy may also be recommended for patients with adrenal hyperplasia, Cushing’s syndrome, primary hyperaldosteronism, or adrenal carcinoma. In cases where the tumor is causing symptoms such as hypertension, palpitations, weight gain, or hormonal imbalances, surgery may be necessary to alleviate these symptoms and prevent further complications. Additionally, patients with large tumors or tumors that are growing rapidly may also be recommended for adrenalectomy to prevent potential complications such as rupture or metastasis. Ultimately, the decision to undergo adrenalectomy should be made on a case-by-case basis by a multidisciplinary team of healthcare providers, taking into account the patient’s overall health, the size and location of the tumor, and the potential risks and benefits of surgery.

Timeline

Before the adrenalectomy:

  • Patient experiences symptoms such as heart problems and a noticeable lump in the stomach
  • Patient undergoes diagnostic tests to identify the tumor in the adrenal gland
  • Treatment plan is discussed with the patient, including the option of adrenalectomy
  • Pre-operative preparations are made, including fasting and medication adjustments

After the adrenalectomy:

  • Patient undergoes the laparoscopic right adrenalectomy procedure
  • Recovery period in the hospital, including monitoring for any complications
  • Post-operative care, including pain management and wound care
  • Follow-up appointments to monitor the patient’s progress and ensure the tumor has been successfully removed
  • Patient resumes normal activities and experiences improved symptoms, such as resolution of heart problems and disappearance of the lump in the stomach

What to Ask Your Doctor

Some questions a patient should ask their doctor about adrenalectomy include:

  1. What are the risks and benefits of undergoing adrenalectomy for my condition?
  2. What is the success rate of laparoscopic adrenalectomy for adrenal tumors, especially larger ones like mine?
  3. How experienced are you and your team in performing laparoscopic adrenalectomy procedures?
  4. What is the expected recovery time and post-operative care needed after the surgery?
  5. Are there any alternative treatment options available for my condition?
  6. How will my adrenal function be affected by the removal of the adrenal gland?
  7. What are the potential long-term effects or complications of adrenalectomy?
  8. Will I need any additional tests or medications after the surgery?
  9. How often will I need follow-up appointments or monitoring after the procedure?
  10. Can you provide me with more information or resources about adrenalectomy and my specific condition?

Reference

Authors: Di Nuzzo MM, Castiglioni S, Pirozzi N, Di Santo Albini AG, De Luca M, Tedesco A, Bardascino F, de Werra C, Corcione F. Journal: Ann Ital Chir. 2023;94:52-55. PMID: 36810354