Treatment of Cushing’s Disease with Bilateral Adrenalectomy and Autotransplantation

Abstract

2 Cases of childhood Cushing’s disease have been treated with bilateral adrenalectomy and autotransplantation of adrenal tissue. Transplantation was unsuccessful in 1 case. In the other patient, replacement therapy was discontinued without any symptoms of hypo- or hyperadrenocorticism. Her urinary 17-hydroxycorticosteroids, free cortisol and aldosterone remain in the low normal range indicating functional adrenal tissue, probably a result of the transplant.

Tissue regenerates of adrenal cortex with a physiological function twelve years after bilateral total adrenalectomy for Cushing's Syndrome

“…A maximum of one third of the grafts are functionally intact and often result in residual Cushing's disease necessitating either a surgical transplant reduction or resection (Demeter et al, 1990;Hardy et al, 1985;Lino et al, 1984;Ribeiro et al, 1976;Xu et al, 1989). The transplants become functional over a period of years and it appears that their steroid secretion is subject to maximal Urban et al, 1980). They don't seem to possess the ability to be regulated physiologically in contrast to the normal ability of the adrenal regenerates in our patient with respect to stimulation and suppression.…”