A rare case of ACTH-independent macronodular adrenal hyperplasia associated with aldosterone-producing adenoma.

Eri Hayakawa, Takanobu Yoshimoto, Kiichiro Hiraishi, Masako Kato, Hajime Izumiyama, Hironobu Sasano, Yukio Hirata

Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.

Internal medicine (Tokyo, Japan) 2011

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A 52-year-old man was evaluated for incidentally discovered bilateral adrenal masses. He had drug-resistant hypertension but lacked Cushingoid features. Endocrinological tests revealed autonomous secretion of cortisol and aldosterone with suppressed plasma ACTH and renin activity. A selective adrenal venous sampling demonstrated aldosterone hypersecretion from the left adrenal vein. The clinical diagnosis of subclinical Cushing's syndrome due to ACTH-independent macronodular adrenal hyperplasia (AIMAH) associated with primary aldosteronism was made, and he underwent left adrenalectomy; the resected adrenal lesion was consistent with the pathological diagnosis of AIMAH coexistent with aldosterone-producing adenoma (APA). This is a very rare case of AIMAH with concomitant unilateral APA, whose hypertension improved after surgery.

Citation

Eri Hayakawa, Takanobu Yoshimoto, Kiichiro Hiraishi, Masako Kato, Hajime Izumiyama, Hironobu Sasano, Yukio Hirata. A rare case of ACTH-independent macronodular adrenal hyperplasia associated with aldosterone-producing adenoma. Internal medicine (Tokyo, Japan). 2011;50(3):227-32