Primary aldosteronism and hypercortisolism due to bilateral functioning adrenocortical adenomas.
A 50-year-old male patient with a 15-year history of hypertension was referred to our hospital for evaluation of bilateral adrenal tumors. No Cushingoid features were observed. Computed tomographic scan showed 10-mm masses in each adrenal gland. Preoperative endocrinological examinations revealed autonomous cortisol and aldosterone secretion in this patient. The results of a subsequent adrenal venous catheterization study were consistent with the presence of a left cortisol-producing tumor and a right aldosterone-producing tumor. A left partial adrenalectomy was performed initially, but cortisol and aldosterone over-secretion persisted. Accordingly, the patient underwent a right adrenalectomy. Pathological examination of the resected specimens, including immunohistochemical analysis, demonstrated that both adenomas possibly produced cortisol and aldosterone. This is an extremely rare case of bilateral adrenal tumors, in which the left adrenocortical tumor produced and secreted cortisol or both cortisol and aldosterone and the right one produced and secreted both aldosterone and cortisol, as confirmed by clinical findings and pathological studies using immunohistochemical analysis.
Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan. kenji-oki@hiroshima-u.ac.jp.
Kenji
K
Oki
Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan.
Kiminori
K
Yamane
Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan.
Yu
Y
Sakashita
Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan.
Nozomu
N
Kamei
Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan.
Hiroshi
H
Watanabe
Department of Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Naoyuki
N
Toyota
Department of Urology, National Hospital Organization Kure Medical Center, Hiroshima, Japan.
Masanobu
M
Shigeta
Department of Pathology, Tohoku University School of Medicine, Miyagi, Japan.
Hironobu
H
Sasano
Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan.
Nobuoki
N
Kohno
D000306:Adrenal Cortex Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D018246:Adrenocortical Adenoma / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D000450:Aldosterone / Q000378:metabolism; D003480:Cushing Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D003937:Diagnosis, Differential; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006929:Hyperaldosteronism / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged
D000450:Aldosterone; D006854:Hydrocortisone