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Endocrine Abstracts (2014) 35 P7 | DOI: 10.1530/endoabs.35.P7

1Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität München, München, Germany; 2Max-Planck-Institut für Psychiatrie, München, Germany; 3Department of Neurosurgery, University Hospital Tuebingen, Tübingen, Germany; 4IMSE, Klinikum rechts der Isar der TU München, München, Germany; 5Chirurgische Klinik und Poliklinik - Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, München, Germany.


Objective: Bilateral adrenalectomy (BADX) is an important treatment option for patients with Cushing’s syndrome (CS). The outcome of this procedure has not been studied well.

The aim was to analyze long-term outcome of CS patients treated with BADX.

Design: Fifty patients with BADX treated since 1990 in two German centers were identified. 34 patients had Cushing’s disease (CD), nine ectopic Cushing-syndrome (ECS), and seven ACTH-independent bilateral adrenal hyperplasia (BAH).

Methods: Standardized follow-up examination was performed in 36 patients with a minimum follow-up time after BADX of 6 months and a median follow-up time of 11 years. Surgical, biochemical and clinical outcome as well as morbidity and mortality were studied.

Results: Surgical morbidity and mortality were 6 and 4%, respectively. All patients went in remission after BADX. Nearly all Cushing’s specific comorbidities except for psychiatric diseases improved significantly. Health related quality of life remained impaired in 45.0% of the female and 16.7% of the male patients compared to healthy population. Median number of adrenal crises per 100 patient-years was four. Nelson tumor occurred in 24% of CD patients after a median time span of 51 months. Long-term mortality after 10 years was high in ECS (44%) compared to CD (3%) and BAH (14%).

Conclusions: BADX is an effective and relatively safe treatment option especially in patients with CD. The majority of patients experience considerable improvement of Cushing’s symptoms.

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