CT-Guided Acetic Acid Injection Therapy for Aldosterone-Producing Adrenocortical Adenoma. A Preliminary Report of Three Cases.

Abstract

Abstract.We reported the preliminary outcomes of CT-guided percutaneous injection therapy for aldosteroneproducing adrenocortical adenoma (APA). Five sessions of injection therapy, 4 percutaneous acetic acid injections (PAI) and 1 percutaneous ethanol injection (PEI) were performed in 3 patients with APA. A small amount of acetic acid or ethanol solution was injected via a needle placed precisely inside the tumor. The procedure was frequently monitored by repetitive CT scanning. The follow-up period ranged from 5 to 27 months. After the treatment, hypertension was normalized or controlled by a low dose of conventional anti-hypertensive drug. In 2 of 3 cases the plasma aldosterone levels were normalized.Although temporary symptoms of alcoholic intoxication were observed in the single session of PEI, the 4 sessions of PAI were associated with no adverse symptoms or complications.Although this study covers only short-term results in 3 patients, CT-guided PAI appears to be a safe and effective treatment and may be a promising alternative as a simple and far less invasive therapy for APA.

Long-term Results after CT-Guided Percutaneous Ethanol Ablation for the Treatment of Hyperfunctioning Adrenal Disorders

“…In patients without pheochromocytoma, cardiovascular effects included hypotension, CNS depression and hypoxemia, myocardial infarction, and tachyarrhythmia associated with hypertension. Hypotension and CNS depression and hypoxemia observed in subject 4 could have resulted from the systemic effects of ethanol 18 , as was also reported in one subject treated by Minowada et al 19 ; this may have been potentiated by prior benzodiazepine and opiate administration. Hypotension has also been observed in image-guided PEA for treating other organs, such as hepatocellular carcinoma in the liver and several cases of cardiovascular collapse have been reported 20 , 21 .…”

Computed Tomography-Guided Percutaneous Acetic Acid Injection Therapy for Functioning Adrenocortical Adenoma

“…In a previous paper published in 2000 we reported the preliminary results of three cases treated with computed tomography (CT)-guided acetic acid injection therapy (9). Here we present 10 cases with adrenal functioning adenoma, including five cases with primary aldosteronism and five with Cushing's syndrome, who underwent CTguided percutaneous acetic acid injection (PAI) therapy between 1997 and 2002.…”

Morphologic Change in Computed Tomography of Aldosterone-Producing Adenoma after Radiofrequency Ablation

“…Image-guided percutaneous radiofrequency ablation (RFA) of the adrenal adenoma is now one of the treatment choices for those who are surgically unfit [6–11]. Other less-invasive nonsurgical techniques were also available, including selective arterial embolization and injection of ethanol and acetic acid [6–11]. The feasibility of computed tomography (CT) guided percutaneous RFA in treating aldosterone-producing adenoma (APA) also had been investigated [12].…”