z-logo
Premium
Concurrent secretion of aldosterone and cortisol from an adrenal adenoma — value of MRI in diagnosis
Author(s) -
Allan Carolyn A.,
Kaltsas Gregory,
Perry Les,
Lowe David G.,
Reznek Rodney,
Carmichael David,
Monson John P.
Publication year - 2000
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.2000.01022.x
Subject(s) - aldosterone , endocrinology , medicine , hydrocortisone , adrenal adenoma , adrenalectomy , adenoma , magnetic resonance imaging , adrenocortical adenoma , stimulation , adrenal gland , adrenal insufficiency , blood pressure , radiology
A 43‐year‐old female with a 24‐years history of hypertension presented for further investigation and management of primary hyperaldosternoism. Postural studies were not conclusive and magnetic resonance (MR) imaging demonstrated a 27 × 18 mm lesion of the right adrenal gland which showed no signal loss during in and out of phase imaging. Although these appearances were considered to be atypical of those seen on MR in patients with aldosterone producing adrenal adenomas the patient underwent an adrenalectomy with removal of a 3 × 3 × 2 cm right adrenal mass. Post‐operatively she became hypotensive and a 0900 hours serum cortisol was undetectable (< 50 nmol/l), consistent with adrenal insufficiency. Following the administration of hydrocortisone there was normalization of the blood pressure and subsequent adrenal stimulation tests confirmed the presence of functioning adrenal tissue albeit with an inadequate response. Cortisol measurement from preoperative samples revealed loss of normal diurnal rhythm whereas DHEAS levels both pre and postoperatively were undetectable, consistent with ACTH supression resulting from autonomous cortisol secretion in addition to aldosterone. Concurrent secretion of cortisol should always be considered in Conn's adenomas particularly when atypical radiological features are present.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here