title: A rare case of ACTH-independent macronodular adrenal hyperplasia associated with aldosterone-producing adenoma.
abstract: A 52-year-old man was evaluated for incidentally discovered bilateral adrenal masses. He had drug-resistant hypertension but lacked Cushingoid features. Endocrinological tests revealed autonomous secretion of cortisol and aldosterone with suppressed plasma ACTH and renin activity. A selective adrenal venous sampling demonstrated aldosterone hypersecretion from the left adrenal vein. The clinical diagnosis of subclinical Cushing's syndrome due to ACTH-independent macronodular adrenal hyperplasia (AIMAH) associated with primary aldosteronism was made, and he underwent left adrenalectomy; the resected adrenal lesion was consistent with the pathological diagnosis of AIMAH coexistent with aldosterone-producing adenoma (APA). This is a very rare case of AIMAH with concomitant unilateral APA, whose hypertension improved after surgery.
authors.affiliation: Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Hayakawa
authors.forename: Takanobu
authors.initials: T
authors.lastname: Yoshimoto
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Hiraishi
authors.forename: Masako
authors.initials: M
authors.lastname: Kato
authors.forename: Hajime
authors.initials: H
authors.lastname: Izumiyama
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hirata
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000378:metabolism / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000378:metabolism / Q000601:surgery; D000311:Adrenal Glands / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D000315:Adrenalectomy; D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D000450:Aldosterone / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006973:Hypertension / Q000503:physiopathology; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000450:Aldosterone; D000324:Adrenocorticotropic Hormone