title: Laparoscopic adrenalectomy for bilateral metachronous aldosteronomas.
abstract: BACKGROUND
  Primary aldosteronism affects 5% to 13% of patients with hypertension. Idiopathic bilateral hyperplasia (IHA) and unilateral aldosterone-producing adenoma (APA) are the most common types of primary aldosteronism. Bilateral APA is a very rare entity with only a few reports in the literature. We present the case of a patient with metachronous bilateral APA treated with metachronous bilateral total and near total adrenalectomy.
  
  
  METHODS
  A 66-year-old female was evaluated for hypokalemia and hypertension refractory to medical therapy 2 years after laparoscopic adrenalectomy for right APA. Follow-up abdominal CT scan revealed a new 1.1-cm left adrenal mass. The patient underwent a laparoscopic near total adrenalectomy for her new left adrenal mass. Pathology examination revealed a new APA. The operation and the patient's postoperative course were uneventful. Potassium levels were normalized and her hypertension became well controlled.
  
  
  CONCLUSIONS
  APA can present metachronously months to years after adrenalectomy for APA in the contralateral adrenal gland. Laparoscopic adrenalectomy remains the approach of choice for this pathology.
authors: Department of Surgery, New York Methodist Hospital, Brooklyn, New York 11215, USA.
authors: Philippe
authors: P
authors: Rizek
authors: Piotr
authors: P
authors: Gorecki
authors: Aristid
authors: A
authors: Lindenmayer
authors: Sabita
authors: S
authors: Moktan
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D018246:Adrenocortical Adenoma / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000450:Aldosterone / Q000097:blood; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016609:Neoplasms, Second Primary / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D000450:Aldosterone