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’Malignant’ hypertension from hyperaldosteronism: a case report

Adrenocortical carcinomas (ACC) are rare with an incidence of 0.7-2 per million population per year and account for only 0.05%-2% of all malignant tumors. While majority of the functional ACC present as Cushing syndrome, recurrent hyperaldosteronism from metastatic ACC is exceedingly rare. We descri...

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Autores principales: Baradhi, Krishna Mohan, Tran, Thao, Mittadodla, Penchala Swamy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093592/
https://www.ncbi.nlm.nih.gov/pubmed/30123413
http://dx.doi.org/10.11604/pamj.2018.30.10.14015
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author Baradhi, Krishna Mohan
Tran, Thao
Mittadodla, Penchala Swamy
author_facet Baradhi, Krishna Mohan
Tran, Thao
Mittadodla, Penchala Swamy
author_sort Baradhi, Krishna Mohan
collection PubMed
description Adrenocortical carcinomas (ACC) are rare with an incidence of 0.7-2 per million population per year and account for only 0.05%-2% of all malignant tumors. While majority of the functional ACC present as Cushing syndrome, recurrent hyperaldosteronism from metastatic ACC is exceedingly rare. We describe a 67-year old female presented with hypertensive urgency & hypokalemia as a result of hyperaldosteronism from an 8-cm right ACC. She underwent a radical right nephrectomy with adrenalectomy that normalized her blood pressure. However, a few years later she presented again with resistant hypertension from hyperaldosteronism, raising the suspicion of recurrence of ACC. A contrast-enhanced CT scan showed a normal left adrenal gland but revealed pulmonary metastases of ACC based on a lung biopsy. Chemotherapy was complicated with side effects leading to refusal of further chemotherapy, henceforth requiring high dose of spironolactone for blood pressure control. Despite curative surgery, metastatic functional ACC should be considered in patients presenting with secondary hypertension from recurrent hyperaldosteronism, due to its high recurrence rate. Besides standard cancer surveillance after a curative surgery, meticulous monitoring of blood pressure is a simple yet crucial way to detect cancer recurrence early.
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spelling pubmed-60935922018-08-17 ’Malignant’ hypertension from hyperaldosteronism: a case report Baradhi, Krishna Mohan Tran, Thao Mittadodla, Penchala Swamy Pan Afr Med J Case Report Adrenocortical carcinomas (ACC) are rare with an incidence of 0.7-2 per million population per year and account for only 0.05%-2% of all malignant tumors. While majority of the functional ACC present as Cushing syndrome, recurrent hyperaldosteronism from metastatic ACC is exceedingly rare. We describe a 67-year old female presented with hypertensive urgency & hypokalemia as a result of hyperaldosteronism from an 8-cm right ACC. She underwent a radical right nephrectomy with adrenalectomy that normalized her blood pressure. However, a few years later she presented again with resistant hypertension from hyperaldosteronism, raising the suspicion of recurrence of ACC. A contrast-enhanced CT scan showed a normal left adrenal gland but revealed pulmonary metastases of ACC based on a lung biopsy. Chemotherapy was complicated with side effects leading to refusal of further chemotherapy, henceforth requiring high dose of spironolactone for blood pressure control. Despite curative surgery, metastatic functional ACC should be considered in patients presenting with secondary hypertension from recurrent hyperaldosteronism, due to its high recurrence rate. Besides standard cancer surveillance after a curative surgery, meticulous monitoring of blood pressure is a simple yet crucial way to detect cancer recurrence early. The African Field Epidemiology Network 2018-05-04 /pmc/articles/PMC6093592/ /pubmed/30123413 http://dx.doi.org/10.11604/pamj.2018.30.10.14015 Text en © Krishna Mohan Baradhi et al. http://creativecommons.org/licenses/by/2.0/ The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Baradhi, Krishna Mohan
Tran, Thao
Mittadodla, Penchala Swamy
’Malignant’ hypertension from hyperaldosteronism: a case report
title ’Malignant’ hypertension from hyperaldosteronism: a case report
title_full ’Malignant’ hypertension from hyperaldosteronism: a case report
title_fullStr ’Malignant’ hypertension from hyperaldosteronism: a case report
title_full_unstemmed ’Malignant’ hypertension from hyperaldosteronism: a case report
title_short ’Malignant’ hypertension from hyperaldosteronism: a case report
title_sort ’malignant’ hypertension from hyperaldosteronism: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093592/
https://www.ncbi.nlm.nih.gov/pubmed/30123413
http://dx.doi.org/10.11604/pamj.2018.30.10.14015
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