Bilateral Laparoscopic Partial Adrenalectomy: A Case Presentation and Review of the Literature
Bibliographic record
Abstract
Laparoscopic adrenalectomy is the standard of care for benign adrenal diseases. Partial adrenalectomy has been performed for various tumors to preserve adrenal function while avoiding steroid supplements postoperatively. This article discusses a patient that underwent bilateral laparoscopic partial adrenalectomies for bilateral pheochromocytomas and reviews the literature on partial adrenalectomy. A 40-year-old woman with a recent diagnosis of hypertension and an emergent Caesarian section for pre-eclampsia presented to an outside clinic with labile blood pressure, diaphoresis, palpitations, and headache. Physical examination was unremarkable with no bruits appreciated in the neck or abdomen. Medical management of her hypertension was initiated with minimal response. Ultimately, a 24-h urine demonstrated elevated urinary metanephrine and normetanephrine levels consistent with a pheochromocytoma. An abdomen and pelvis computed tomogram revealed bilateral, discrete, solid adrenal masses measuring 3.9 × 3.3 cm and 2.3 × 2.7 cm on the left and right, respectively. Selective adrenal venous sampling confirmed bilateral biochemically active pheochromocytomas. Bilateral laparoscopic partial adrenalectomies were performed using laparoscopic staplers to divide the tumor from the normal gland. Both adrenal veins were preserved. Glucocorticoid function was monitored by serial cortisol measurements and glucocorticoid supplementation was initiated on postoperative day one with a 4-week taper. At 1-year follow-up, she remains asymptomatic with a normal blood pressure, cortisol levels, and urine catecholamines. Laparoscopic partial adrenalectomies for bilateral pheochromocytomas are safe and effective. Partial resections preserve adrenal function while eradicating long-term steroid requirements.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".