Cushing’s syndrome (CS) is caused by over-production of a type of hormone called glucocorticoids. The most important one is called cortisol. These hormones are made by the adrenal cortex. Glucocorticoids regulate how the body handles protein and glucose. They affect immunology and the inflammatory response. They influence blood pressure and the bodies’ response to stress. …Read More »
Author: Dr. Kirk Faust
Pheochomocytoma
Pheochromocytoma (pheo) is a rare tumor of the central part of the adrenal gland. As described on other pages, this portion of the adrenal gland is called the medulla. It makes epinephrine (adrenalin) and other vasoactive hormones call catecholamines. These hormones control the bodies’ “flight or fight” reflex. Tumors developing here may be malignant, but …Read More »
Incidentaloma
Four to 6% of adult patients have an adrenal mass. These tumors are found, incidentally, on CT scans or MRI done to evaluate unrelated signs and symptoms. Adrenal tumors found in this way are known as incidentalomas. When an adrenal mass is discovered unexpectedly, two questions must be answered: Is it cancer? Is it functioning? …Read More »
Adrenal Gland Metastasis
Because of the vascularity of the adrenal glands, metastasis from cancer starting in other organs is not uncommon. Lung, breast and colon cancer may spread to the adrenal glands. Melanoma and lymphoma are other malignancies that can metastasize to the adrenals. Occasionally, When a isolated metastasis to one adrenal gland is found and on detailed …Read More »
Laparoscopic Adrenalectomy
The patient pictured above is about 1 week post-op following a transabdominal laparoscopic adrenalectomy for a large pheochromocytoma. Four small incisions are seen in the left upper abdomen. The longer incision is where the tumor was removed. Laparoscopic adrenalectomy is the standard of care for most adrenal tumors. It hurts less and the time in …Read More »
Preoperative Care for Adrenalectomy
Generally, little specific pre-op care for adrenalectomy is needed. If the patient smokes, stopping for even a few days can help minimize airway irritation and coughing. Generally, the patient should continue all of their pre-op medication including aspirin. Coumadin, a common blood thinner, should be discontinued at least 5 days before the surgery. We’ll discuss …Read More »
Postoperative Issues After Adrenalectomy
Patients do very well after laparoscopic adrenalectomy. There is relatively little discomfort, usually well controlled with moderate narcotic based medication. Patients are up walking the evening of surgery. A regular diet is started once post-op nausea is resolved. Essentially all patients, except those with pheochromocytoma go home the day following surgery. All wounds are closed …Read More »
Laryngocopy Slide Show
Understandably, most people are anxious about the idea of laryngoscopy. However, with good local anesthesia and a very narrow flexible fiberoptic scope, the procedure is painless with very little local discomfort. The first part of the procedure involves administering a local anesthetic and vasoconstrictor into the nose and the back of the mouth. The patient …Read More »
Parathyroid Gland
If you look carefully at the picture above you can see a normal parathyroid gland. The left thyroid lobe is being elevated out of the wound. Just below the silver retractor a small, faintly tan, structure can be appreciated just deep to the upper aspect of the thyroid. This is a normal parathyroid gland. In …Read More »
Primary Hyperparapthrydoidism (1˚HPT)
This is a parathyroid adenoma. It is a benign growth of one of the parathyroid glands and is the most common cause of 1°HPT. This gland weighs about 500 mg (about 10× normal size) and it is a typical parathyroid adenoma. One can appreciate how it is different from the normal parathyroid gland seen on …Read More »