title: Adrenocortical carcinoma, an unusual cause of secondary hypertension.
abstract: We present the case of a female patient aged 39 years who was admitted to our hospital due to hypertension, severe hypokalaemia and metabolic alkalosis; physical examination was remarkable for plethoric moon face, centripetal obesity and bilateral lower extremity oedema. She was admitted for intravenous potassium replacement and further assessment of hypertension and associated clinical findings. Laboratory testing showed increased levels of aldosterone, renin, cortisol, testosterone and androstenedione. An abdominal CT revealed a large mass in the right adrenal gland with hepatic involvement. The patient was started on antihypertensive medications and underwent laparoscopic surgery for mass and liver biopsy. The pathological diagnosis was adrenocortical carcinoma with liver metastasis. Hyperaldosteronism is a cause of secondary hypertension and its diagnosis is usually benign. Adrenocortical carcinoma is a rare condition and aldosterone secreting tumours are even rarer; associated hypertension usually improves after tumour resection, but with the presence of metastasis, blood pressure control is difficult.
authors.affiliation: Department of Cardiology, Hospital Español de México, Ciudad de Mexico, Mexico.
authors.forename: Daniel
authors.identifier: http://orcid.org/0000-0002-3543-6360
authors.initials: D
authors.lastname: Veron Esquivel
authors.affiliation: Department of Cardiology, Hospital Español de México, Ciudad de Mexico, Mexico.
authors.forename: Fernando
authors.initials: F
authors.lastname: Batiz
authors.affiliation: Department of Cardiology, Hospital Español de México, Ciudad de Mexico, Mexico.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Farias Vega
authors.affiliation: Department of Endocrinology, Hospital Regional Licenciado Adolfo Lopez Mateos, Ciudad de Mexico, Mexico.
authors.forename: Perla A
authors.initials: PA
authors.lastname: Carrillo Gonzalez
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications* / Q000175:diagnosis; D018268:Adrenocortical Carcinoma / Q000150:complications* / Q000175:diagnosis; D000328:Adult; D001706:Biopsy; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed