Primary Aldosteronism with Bilateral Multiple Aldosterone-Producing Adrenal Adenomas

• Published in: Internal Medicine Vol. 35; no. 12; pp. 970 - 975
• Main Authors: MATSUDA, Akira, BENIKO, Mutsuo, IKOTA, Akemi, YAMAZAKI, Masao, KOIZUMI, Shigeki, MIZUMOTO, Hiroaki, WATANABE, Takeo, MATSUYA, Kumiko, KUNITA, Haruhiko, MASHIO, Yasuo, SASANO, Hironobu
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 1996; Japanese Society of Internal Medicine
• Subjects: Adenoma - metabolism; Adenoma - pathology; Adrenal Gland Neoplasms - metabolism; Adrenal Gland Neoplasms - pathology; Adrenals. Adrenal axis. Renin-angiotensin system (diseases); Adrenocorticotropic Hormone; Adult; Aldosterone - metabolism; aldosterone-producing adenoma; bilateral adrenocortical lesions; Biological and medical sciences; Circadian Rhythm; Dexamethasone; Endocrinopathies; Female; Humans; Hydrocortisone - blood; Hyperaldosteronism - etiology; Medical sciences; Non tumoral diseases. Target tissue resistance. Benign neoplasms; steroidogenic enzymes; Endocrinopathy; Human; Immunohistochemistry; Adrenal cortex diseases; Radiodiagnosis; Hyperaldosteronism; Adrenal cortex; Hyperadrenocorticism; Differential diagnostic; Case study; Association; Histopathology; Adrenal gland diseases; Medical imagery; Steroidogenesis; Computerized axial tomography; Lesion
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.35.970

A 41-year-old woman developed primary aldosteronism due to bilateral multiple aldosterone-producing adenomas (APA). She was suspected to have idiopathic hyperaldosteronism (IHA) 7 years previously. Although preoperative data suggested APA and IHA was suspected in a postoperative microscopic specimen, a definite clinical diagnosis could not be made. Cytochrome P-450 and other enzymes involved in aldosterone synthesis were found in the tumor portions but not in the zona glomerulosa of attached adrenals, which histopathologically showed "paradoxical hyperplasia". This was a rare case of bilateral multiple APA, which could be differentiated from IHA by immunohistochemical analysis of adrenal steroidogenic enzymes. (Internal Medicine 35: 970-975, 1996)