Journal
JOURNAL OF THE ENDOCRINE SOCIETY
Volume 3, Issue 9, Pages 1678-1681Publisher
ENDOCRINE SOC
DOI: 10.1210/js.2019-00092
Keywords
adrenocortical carcinoma; hyperaldosteronism; hypokalemia; adrenal mass
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Adrenocortical carcinoma (ACC) is a rare malignancy that usually is detected as a result of symptoms of hormone excess or mass effect. We describe a rare presentation of ACC with primary aldosterone production leading to profound hypokalemia and cardiac arrest. The patient was previously asymptomatic with low-grade, untreated hypertension and no documented electrolyte abnormalities. She had sudden cardiac arrest, and potassium levels were undetectable. After successful resuscitation, imaging showed a 6-cm left adrenal mass highly suspicious for malignancy. Biochemical workup revealed aldosterone excess as well as cortisol excess, despite the absence of Cushingoid symptoms. Histopathological examination after surgical resection demonstrated high-grade ACC. This case illustrates that the workup of cardiac arrest as a result of electrolyte abnormalities should include evaluation for adrenal pathology. Copyright (C) 2019 Endocrine Society
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