Bilateral adrenalectomy in the 21st century: when to use it for hypercortisolism?
- Carole Guerin1,
- David Taieb2,
- Giorgio Treglia3,
- Thierry Brue4,
- André Lacroix5,
- Frederic Sebag1 and
- Frederic Castinetti4⇑
- 1Aix-Marseille University, Assistance Publique Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, Marseille, France
2Aix-Marseille University, Assistance Publique Hopitaux de Marseille, Department of Nuclear Medicine, La Timone Hospital, Marseille, France
3Department of Nuclear Medicine, Thyroid and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona and Lugano, Switzerland
4Aix-Marseille University, Assistance Publique Hopitaux de Marseille, Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, France
5Endocrine Division, Department of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
- Correspondence should be addresses to F Castinetti; Email: Frederic.castinetti{at}ap-hm.fr
Abstract
Therapeutic options available for the treatment of Cushing's syndrome (CS) have expanded over the last 5 years. For instance, the efficient management of severe hypercortisolism using a combination of fast-acting steroidogenesis inhibitors has been reported. Recent publications on the long-term efficacy of drugs or radiation techniques have also demonstrated low toxicity. These data should encourage endocrinologists to reconsider the place of bilateral adrenalectomy in patients with ACTH-dependent aetiologies of CS; similarly, the indication of bilateral adrenalectomy is reassessed in primary bilateral macronodular adrenal hyperplasia. The objective of this review is to compare the efficacy and side effects of the various therapeutic options of hypercortisolism with those of bilateral adrenalectomy, in order to better define its indications in the 21st century.
- Revision received 30 November 2015
- Accepted 3 December 2015
- © 2016 Society for Endocrinology
