Kangbo Knife Cryoablation for the Treatment of Functional Adrenal Tumors.

Abstract

Aldosterone-producing adenomas and cortisol-secreting adenomas are among the most common functional tumors of the adrenal gland. Primary aldosteronism often leads to refractory hypertension and significantly increases the long-term risk of stroke and cardiovascular events. Autonomous cortisol-secreting adenomas are associated with various complications, including hypertension, hyperglycemia, osteoporosis, infections, and thrombosis. This report presented 2 cases of adrenal tumors: one case involving an aldosterone-producing adenoma and the other involving a cortisol-secreting adenoma. The endocrine functionality of these tumors was assessed using standardized endocrine function tests, including supine and standing aldosterone tests and dexamethasone suppression tests. Bilateral adrenal vein blood sampling (AVS) was performed to localize the lesion responsible for the conditions. Both patients underwent treatment with Kangbo knife cryoablation. No immediate adverse events, such as puncture site pain, hematoma, or pneumothorax, were observed following the procedure. The patient with cortisol-secreting adenoma developed a postoperative pulmonary infection and minor pulmonary thrombosis, which were successfully managed. Postoperatively, both patients achieved biochemical remission, with normalization of aldosterone and cortisol levels. Clinical symptoms, including hypertension, hypokalemia, and moon facies, were significantly improved. Currently, there are no published reports on the use of cryoablation for the treatment of adrenal cortisol-secreting adenomas. To our knowledge, this study presents the first documented cases of AVS-guided Kangbo knife cryoablation for the treatment of aldosterone-producing adenoma and autonomous cortisol-secreting adenoma. The favorable clinical and biochemical outcomes achieved in this study highlight the potential of Kangbo knife cryoablation as a safe and effective novel therapeutic approach for these functional adrenal tumors.