Table 3.
Results from the adrenal venous sampling (AVS), treatment, histopathological findings and outcome
| Patient no | Interpretation of the AVS | Treatment | Pathology | Follow-up months | Treatment response |
|---|---|---|---|---|---|
| 1 | Right-sided hypercortisolism | Right-sided laparoscopic adrenalectomy | Adrenal adenoma | 31 | Postoperative adrenal insufficiency, 13 kg weight reduction, improved blood pressure and significantly increased muscle strength |
| 2 | Bilateral hypercortisolism | Steroidogenesis inibitor | – | 85 | Significantly improved general well-being and insulin sensitivity |
| 3 | Bilateral hypercortisolism | Steroidogenesis inibitor for 4 months, thereafter surveilance | – | 86 | No improvement after 4 months on medical therapy. No progress of symptoms during active surveilance |
| 4 | Bilateral hypercortisolism | Steroidogenesis inibitor | – | 12 | Improved general well-being |
| 5 | Bilateral hypercortisolism | Steroidogenesis inibitor for 4 months, thereafter surveillance | – | 23 | No improvement on medical therapy, rather deterioration with lethargy and malaise |
| 6 | Bilateral hypercortisolism | Steroidogenesis inibitor for 6 months, thereafter surveillance | – | 50 | Improved general well-being on medical treatment, discontinued due to side-effects. During active surveillance, 25 kg weight reduction and resolusion of DM |
| 7 | Left-sided hypercortisolism | Left-sided adrenalectomy | Adrenal adenoma | 51 | Postoperative adrenal insufficiency. Resolution of all CS features, including hypertension, DM and depression |
| 8 | Bilateral hypercortisolism | Bilateral laparoscopic adrenalectomy | PBMAH | 52 | 20 kg weight reduction. Improved blood pressure and general well-being |
| 9 | Bilateral hypercortisolism | Bilateral laparoscopic adrenalectomy | PPNAD | 107 | Resolution of all CS features. Restoration of regular menstruation and improved general well-being |
| 10 | Bilateral hypercortisolism | Bilateral laparoscopic adrenalectomy | PPNAD | 6 | Resolution of all CS features |
| 11 | Bilateral hypercortisolism | TSS | ACTH-positive pituitary adenoma | 27 | Postoperative adrenal insufficiency and resolution of CS features |
Follow-up months from adrenal venous sampling until the last visit or until 31 December 2017
CS Cushing’s syndrome, ACTH adrenocorticotropic hormone, CS Cushing’s syndrome, AVS adrenal venous sampling, DM diabetes mellitus type 2, PBMAH primary bilateral macronodular hyperplasia, PPNAD primary pigmented nodular adrenocortical disease, TSS transsphenoidal surgery