Journal
INTERNAL MEDICINE
Volume 62, Issue 18, Pages 2685-2691Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.1012-22
Keywords
pheochromocytoma; primary aldosteronism; multiple aldosterone-producing micronodules; coexistence
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This is a case of a patient referred for hypertension and a right adrenal tumor, who was later found to have coexistent PA and pheochromocytoma. Histology of the resected adrenal gland confirmed the presence of multiple aldosterone-producing micronodules. Following surgery, urinary catecholamine levels normalized, hyperaldosteronism improved but persisted, and hypertension normalized with spironolactone.
A 46-year-old woman was referred for hypertension and a right adrenal tumor. Primary aldosteronism (PA) was suspected because of the high plasma aldosterone concentration-to-plasma renin activity ratio. However, a subsequent evaluation revealed coexistent PA and pheochromocytoma. We performed laparoscopic right adrenalectomy. Histology of the resected adrenal gland confirmed pheochromocytoma and multiple aldosterone-producing adrenocortical micronodules. Following adrenalectomy, the urinary catecholamine lev-els normalized, and hyperaldosteronism improved but persisted. Hypertension also improved but persisted and was normalized with spironolactone. The clinical course indicated that the PA lesions were likely bilateral. This was a histologically proven case of coexistent pheochromocytoma and PA due to multiple aldosterone-producing micronodules.
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