P-333: Primary aldosteronism and cushing's syndrome treated by CT-guided radiofrequency thermal ablation in SR-Adenomas

Purpose: Evaluation of the feasibility and the effectiveness of Radiofrequency Thermal Ablation (RFTA) in the percutaneous treatment of functioning SR-Adenomas in patients with secondary HBP due to primary hyperaldosteronism and in patients with Cushing's syndrome. Material and Methods: It is described the technique used for RTFA applied to the treatment of adrenal tumors in 11 patients (5 male and 6 female) all Caucasian. Three patients were submitted to percutaneous CT-guided biopsy prior to RTFA. RFTA was applied for primary hyperaldosteronism in 9 patients (5 male and 4 female) and for Glico corticoid tumors in two female patients. We analyzed and compared clinical improvement including HBP, reduction of drugs intake and correlated age and time of HBP diagnosis with the results achieved with this new therapeutical method.; lab values of plasm renin activation (PRA), plasm concentration of aldosterone (PCA); glycemia, cortisol, urinary free cortisol (UFC) and ACTH were determined. Complications and hospital stay as well as costs were also analyzed. Results: Results were calculated using clinical control, lab values and HBP six months after RFTA. In this small group treated by RFTA we achieved normal BP in 9 patients (73%). In the remaining patients we reduced the diary intake of anti-hypertensive drugs. In the group treated for secondary HBP due to hyperaldosteronism with RFTA we achieved cure in 6 patients (66,7%); in those patients treated for Glico corticoid tumors we got cure in both (plasm levels of cortisol normalized within 24h). This means that we could obtain by RFTA good clinical results in an overall of 8 of the 11 patients. The mean hospital stay for RFTA was 4 days in patients with primary hyperaldosteronism and 9 days in those with Cushing's syndrome. Conclusions: The therapeutical results obtained by the use of this new promising method (RFTA) is comparable, despite the short time of follow-up and the few number of patients, to those achieved by percutaneous ethanol injection (less costs) or by surgery (more expensive).