ADRENAL, HYPERTENSION, RENAL PHYSIOLOGY AND RENAL FAILURE Subtotal Adrenalectomy for Phaeochromocytoma in Multiple Endocrine Neoplasia Type 2A

Editorial Comment: In this series 6 patients followed for an average of 40 months had undergone subtotal adrenalectomy with the only remaining tissue being a portion of cortex. Followup adrenal stimulation tests revealed adequate adrenal reserve in all patients. There was 1 case of recurrence. The technique of the authors involves careful preservation of the adrenal vein and use of the argon coagulator. Others have reported similar recurrence rates following subtotal adrenalectomy, that is about a fifth of the patients have disease recurrence. I think that this article emphasizes the fact that a subtotal adrenalectomy can be performed successfully with preservation of cortical adrenal tissue, and so it is responsive to adrenocorticotropic hormone therapy. Whether this preservation of tissue is wise with respect to recurrent disease remains problematic.