title: Distinguishing aldosterone-producing adenoma from other forms of hyperaldosteronism and lateralizing the tumour pre-operatively.
abstract: In 14 hypertensive patients aldosterone/cortisol ratio was always lower in a peripheral vein or low IVC than in either adrenal vein. In four patients with a right-sided aldosterone-producing adenoma (APA), the aldosterone/cortisol ratio in peripheral vein was always higher than in the left adrenal vein. If only the left adrenal vein is cannulated, right-sided APA can still be diagnosed with certainty. In three patients with glucocorticoid-suppressible hyperaldosteronism, urinary excretion of both 18-oxocortisol and 18-hydroxycortisol was elevated. In four patients with APA excretion of 18-oxocortisol was elevated. In two of three patients with bilateral adrenal hyperplasia (BH), excretion of both steroids was normal. 75Se-selenomethylcholesterol scanning correctly lateralized five APA, but falsely lateralized a patient with BH. Results with CT scans were often misleading.
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism; D000305:Adrenal Cortex Hormones / Q000097:blood / Q000652:urine; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D000450:Aldosterone / Q000378:metabolism*; D003937:Diagnosis, Differential; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis*
chemical_list: D000305:Adrenal Cortex Hormones; D000450:Aldosterone