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SUN-LB36 Primary Aldosteronism Due Tosimultaneous Occurrence of Aldosteronoma in the Left Adrenal Gland and Ectopicaldosteronoma in the Liver: A Case Report

Rationale: Ectopic adrenal tissue is the adrenal rests along the path from gonads to adrenal glands during embryogenesis. Ectopic aldosteronoma is a rare disease presented with over-production of aldosterone by the ectopic adrenocortical tissue. Diagnosis is a clinical challenge with simultaneous oc...

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Autores principales: He, Xiaoying, Huang, Zhimin, Ke, Weijian, Li, Yanbing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209557/
http://dx.doi.org/10.1210/jendso/bvaa046.2246
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author He, Xiaoying
Huang, Zhimin
Ke, Weijian
Li, Yanbing
author_facet He, Xiaoying
Huang, Zhimin
Ke, Weijian
Li, Yanbing
author_sort He, Xiaoying
collection PubMed
description Rationale: Ectopic adrenal tissue is the adrenal rests along the path from gonads to adrenal glands during embryogenesis. Ectopic aldosteronoma is a rare disease presented with over-production of aldosterone by the ectopic adrenocortical tissue. Diagnosis is a clinical challenge with simultaneous occurrence of ectopic aldosteronoma. To our knowledge this is the first reported case of simultaneous occurrence of aldosteronoma in the adrenal gland and ectopic aldosteronoma in the liver based on literatures. Patient concerns: A 33-year-old woman presented with resistant hypertension and severe hypokalemea for 3 years. 5 months ago, the patient was diagnosed as aldosteronoma in left adrenal gland and underwent right adrenalectomy. The histopathological examination of the resected sample suggested adrenal cortical adenoma. The patient still had symptoms of hypertension and hypokalemia after operation, but the blood potassium level was higher than that before operation (minimum blood potassium level rose from 1.8 mmol/L to 2.6 mmol/L). Diagnosis: The saline load test, captopril test, and plasma aldosterone/renin ratio were indicative of primary aldosteronism (PA). The computed tomographic scan (CT) was suggestive of a low-density mass (2.9×2.2 cm) in the liver which was very near to the right adrenal area. Magnetic resonance imaging (MRI) further confirmed that the lesion was located in the liver. PET-CT eliminated the possibility of metastasis to other parts of the body. Ultrasound guided biopsy confirmed that the tumor was ectopic adrenal tissue in the liver. Interventions: Ultrasound-guided percutaneous radiofrequency ablation was performed to the tumor in the liver.Outcomes: The patient’s blood potassium level was 3.8 mmol/L on the third day after the ablation without any potassium supplementation treatments. On follow-up of 2-weeks duration, the patient has g good control over her blood pressure of around 126/74 mmHg and blood potassium of 4.55 mmol/L, without taking any medications. Lessons: The patient was diagnosed with PA due to simultaneous occurrence of aldosteronoma in the left adrenal gland and ectopic aldosteronoma in the liver, which is very rare. Ultrasound-Guided Percutaneous Radiofrequency Ablation is a safe and effective treatment for ectopic aldosteronoma in liver.
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spelling pubmed-72095572020-05-13 SUN-LB36 Primary Aldosteronism Due Tosimultaneous Occurrence of Aldosteronoma in the Left Adrenal Gland and Ectopicaldosteronoma in the Liver: A Case Report He, Xiaoying Huang, Zhimin Ke, Weijian Li, Yanbing J Endocr Soc Adrenal Rationale: Ectopic adrenal tissue is the adrenal rests along the path from gonads to adrenal glands during embryogenesis. Ectopic aldosteronoma is a rare disease presented with over-production of aldosterone by the ectopic adrenocortical tissue. Diagnosis is a clinical challenge with simultaneous occurrence of ectopic aldosteronoma. To our knowledge this is the first reported case of simultaneous occurrence of aldosteronoma in the adrenal gland and ectopic aldosteronoma in the liver based on literatures. Patient concerns: A 33-year-old woman presented with resistant hypertension and severe hypokalemea for 3 years. 5 months ago, the patient was diagnosed as aldosteronoma in left adrenal gland and underwent right adrenalectomy. The histopathological examination of the resected sample suggested adrenal cortical adenoma. The patient still had symptoms of hypertension and hypokalemia after operation, but the blood potassium level was higher than that before operation (minimum blood potassium level rose from 1.8 mmol/L to 2.6 mmol/L). Diagnosis: The saline load test, captopril test, and plasma aldosterone/renin ratio were indicative of primary aldosteronism (PA). The computed tomographic scan (CT) was suggestive of a low-density mass (2.9×2.2 cm) in the liver which was very near to the right adrenal area. Magnetic resonance imaging (MRI) further confirmed that the lesion was located in the liver. PET-CT eliminated the possibility of metastasis to other parts of the body. Ultrasound guided biopsy confirmed that the tumor was ectopic adrenal tissue in the liver. Interventions: Ultrasound-guided percutaneous radiofrequency ablation was performed to the tumor in the liver.Outcomes: The patient’s blood potassium level was 3.8 mmol/L on the third day after the ablation without any potassium supplementation treatments. On follow-up of 2-weeks duration, the patient has g good control over her blood pressure of around 126/74 mmHg and blood potassium of 4.55 mmol/L, without taking any medications. Lessons: The patient was diagnosed with PA due to simultaneous occurrence of aldosteronoma in the left adrenal gland and ectopic aldosteronoma in the liver, which is very rare. Ultrasound-Guided Percutaneous Radiofrequency Ablation is a safe and effective treatment for ectopic aldosteronoma in liver. Oxford University Press 2020-05-08 /pmc/articles/PMC7209557/ http://dx.doi.org/10.1210/jendso/bvaa046.2246 Text en © Endocrine Society 2020. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Adrenal
He, Xiaoying
Huang, Zhimin
Ke, Weijian
Li, Yanbing
SUN-LB36 Primary Aldosteronism Due Tosimultaneous Occurrence of Aldosteronoma in the Left Adrenal Gland and Ectopicaldosteronoma in the Liver: A Case Report
title SUN-LB36 Primary Aldosteronism Due Tosimultaneous Occurrence of Aldosteronoma in the Left Adrenal Gland and Ectopicaldosteronoma in the Liver: A Case Report
title_full SUN-LB36 Primary Aldosteronism Due Tosimultaneous Occurrence of Aldosteronoma in the Left Adrenal Gland and Ectopicaldosteronoma in the Liver: A Case Report
title_fullStr SUN-LB36 Primary Aldosteronism Due Tosimultaneous Occurrence of Aldosteronoma in the Left Adrenal Gland and Ectopicaldosteronoma in the Liver: A Case Report
title_full_unstemmed SUN-LB36 Primary Aldosteronism Due Tosimultaneous Occurrence of Aldosteronoma in the Left Adrenal Gland and Ectopicaldosteronoma in the Liver: A Case Report
title_short SUN-LB36 Primary Aldosteronism Due Tosimultaneous Occurrence of Aldosteronoma in the Left Adrenal Gland and Ectopicaldosteronoma in the Liver: A Case Report
title_sort sun-lb36 primary aldosteronism due tosimultaneous occurrence of aldosteronoma in the left adrenal gland and ectopicaldosteronoma in the liver: a case report
topic Adrenal
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209557/
http://dx.doi.org/10.1210/jendso/bvaa046.2246
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