Successful autotransplantation of an adrenal gland using a new method of omental wrapping: report of a case.

Bilateral total adrenalectomy results in the need for patients to take lifelong supplements of adrenal steroids, with the risk of possible Addisonian crisis. Few reports of the successful autotransplantation of adrenal tissue in muscular pockets have been documented; however, we describe herein the case of a 22-year-old woman in whom autotransplantation of an adrenal gland was successfully performed employing a new method of omental wrapping. The patient underwent bilateral total adrenalectomy for bilateral pheochromocytoma at which time adrenal tissue was sliced into 1-2-mm thick pieces, half of which were placed in muscular pockets in the abdominal rectus muscles, and the remaining half put onto the omentum and wrapped with it. Laboratory examinations done 6 months after surgery showed recovery of her adrenal function, and 4 months later steroid supplements were able to be discontinued. Scintigraphic studies using [131I]-iodomethyl-norcholesterol ([131]I-Adosterol) demonstrated clear activity in the omentum, weak activity in the rectus muscles, and no activity in the adrenal beds. These findings suggest that the omentum may be more suitable as an implantation site for adrenal tissue than muscular pockets.