Mishal Mendiratta-Lala MD, Presenter: Nothing to Disclose

Darren D. Brennan MBBCh, Abstract Co-Author: Nothing to Disclose

Olga Rachel Brook MD, Abstract Co-Author: Nothing to Disclose

Salomao Faintuch MD, Abstract Co-Author: Consultant, Baxter International Inc

Robert G. Sheiman MD, Abstract Co-Author: Nothing to Disclose

S. Nahum Goldberg MD, Abstract Co-Author: Consultant, AngioDynamics, Inc, Fremont, CA Research support, AngioDynamics, Inc, Fremont, CA

Peter Mowschenson MD, Abstract Co-Author: Nothing to Disclose

We describe radiofrequency ablation as primary treatment for symptomatic primary functional adrenal neoplasms, and evaluate the efficacy of treatment utilizing clinical and biochemical follow-up.

Thirteen consecutive patients with symptomatic functional adrenal neoplasms (< 3.2 cm diameter) were treated with radiofrequency ablation (RFA) over seven years. Cross-sectional imaging, clinical symptoms, and adrenal biochemical markers were available for patients who met inclusion criteria. Ten patients (77%) were treated for aldosteronoma, and one patient each for cortisol-secreteing tumor, testosterone-secreting tumor, and pheochromocytoma. RFA was performed using an internally-cooled electrode utilizing pulsed technique according to manufacturer specifications. Clinical and laboratory follow-up were performed for these patients.

All patients demonstrated resolution of abnormal biochemical markers following the procedure (mean biochemical follow-up 21.2 months). Additionally, all patients experienced resolution of clinical symptoms, including hypertension and hypokalemia (aldosteronoma), Cushing’s syndrome (cortisol-secreting tumor), and virilizing symptoms (testosterone-secreting tumor). For the aldosteronoma group improvements in hypertension management were noted. Mean pre-ablation BP was 149/90 on 3.1±0.6 blood pressure medications, which decreased to 122/77 at a mean of 2.8 months post ablation on 1.3±0.9 medications (P<0.001) and remained 124/75 at a mean 41.4 months. Two minor complications included: one small pneumothorax and one small and limited hemothorax; neither of which required overnight admission. Two episodes of transient self-remitting procedural hypertension occurred, in patients with aldosteronoma and cortisol-secreting tumors; however, requiring no further therapy during overnight observation.

Radiofrequency ablation may offer an effective, minimally-invasive treatment of small functional primary adrenal tumors.

RFA offers a minimally-invasive treatment for small functional primary adrenal tumors, therefore, decreased likelihood of procedural complication when compared to traditional surgical resection.

Mendiratta-Lala, M, Brennan, D, Brook, O, Faintuch, S, Sheiman, R, Goldberg, S, Mowschenson, P, Efficacy of Radiofrequency Ablation for the Treatment of Functional Adrenal Neoplasms.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007552.html