Cushing's syndrome in pregnancy in which laparoscopic adrenalectomy was safely performed by a retroperitoneal approach

Author:

Takeuchi Nobuyoshi1ORCID,Imamura Yusuke1,Ishiwata Kazuki2,Kanesaka Manato1,Goto Yusuke1ORCID,Sazuka Tomokazu1ORCID,Suzuki Sawako2,Koide Hisashi2,Sakamoto Shinichi1,Ichikawa Tomohiko1

Affiliation:

1. Department of Urology Chiba University Graduate School of Medicine Chiba Japan

2. Department of Clinical Cell Biology Chiba University Graduate School of Medicine Chiba Japan

Abstract

IntroductionLaparoscopic adrenalectomy is the standard treatment for adrenal tumors caused by Cushing's syndrome. However, few pregnant women have undergone adrenalectomy because of the risk of general anesthesia and surgery.Case presentationA 28‐year‐old woman presented with gradually worsening Cushing's signs at around 12 weeks of pregnancy. Magnetic resonance imaging displayed a 38‐mm left adrenal tumor, which was the cause of the adrenal Cushing's syndrome. Metyrapone was started, which increased androgen levels. Since the management of Cushing's syndrome by medication alone is challenging, unilateral laparoscopic adrenalectomy by a retroperitoneal approach was performed at 23 weeks of the pregnancy. No perioperative complications were noted.ConclusionAdrenalectomy is considered safe in pregnant women with Cushing's syndrome. Laparoscopic adrenalectomy by retroperitoneal approach should be chosen and performed between 14 and 30 weeks of pregnancy to prevent mother and fetal complications.

Publisher

Wiley

Subject

Urology

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