Coexistence of Aldosterone-Producing Adrenocortical Adenoma and Pheochromocytoma in an Ipsilateral Adrenal Gland

Endocrine Journal

Hironobu SASANO²  Keiichi IKEDA³  Naoko TAJIMA¹  Nozomu FURUTA⁴  Noriko SAKAMOTO¹  Tsuyoshi ISAKA¹  Kei FUJIMOTO¹  Takatoshi SAITO¹  Hironori YAMADA⁴  Katsuyoshi TOJO¹ 

[1] Division of Diabetes and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine;Department of Pathology, Tohoku University School of Medicine;Department of Pharmacology, The Jikei University School of Medicine;Department of Urology, The Jikei University School of Medicine

关键词: Adrenal tumor;    Aldosterone-producing adenoma;    Pheochromocytoma;    Hypertension;    Serial MRI;   

DOI  :  10.1507/endocrj.K08E-196

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(15)Cited-By(3)A 40-year-old female, diagnosed as essential hypertension, demonstrated a 2 cm mass in left adrenal gland by computed tomography without abnormal endocrinological findings. 131 I-adosterol and 123 I-metaiodobenzylguanidine (MIBG) scintigraphy at 39 years of age showed no abnormal accumulation. Follow up 131 I-adosterol scintigraphy performed one year later showed apparently abnormal uptake and slightly elevated uptake in left adrenal gland. Her physical examination was unremarkable except for mild hypertension. Routine blood chemistry was normal except for hypokalemia. Endocrinological date revealed suppressed plasma renin activity, and elevated plasma aldosterone concentration, and noradrenalin levels. Serial T2-weighted magnetic resonance imaging clearly demonstrated two distinct tumors. Furthermore, selective adrenal venous sampling with intravenous ACTH infusion indicated aldosterone-producing adrenocortical adenoma (APA) in left adrenal gland. During operation of adrenal tumor, blood pressure elevated markedly and complication of pheochromocytoma (PC) was suspected. Immunohistochemical findings after left adrenolectomy revealed that the adrenal mass was compatible with APA and PC. Risk of operation against undiagnosed PC is very high and, therefore, it must be diagnosed before surgery. Herein, we present an extremely rare case of the simultaneous occurrence of both APA and PC in an ipsilateral adrenal gland.

【 授权许可】

Unknown