Primary Aldosteronism Associated with Multiple Adrenocortical Micronodules in a Patient with Renal Cell Carcinoma.


Journal

Case reports in endocrinology
ISSN: 2090-6501
Titre abrégé: Case Rep Endocrinol
Pays: United States
ID NLM: 101576457

Informations de publication

Date de publication:
2020
Historique:
received: 09 10 2019
accepted: 16 01 2020
entrez: 12 3 2020
pubmed: 12 3 2020
medline: 12 3 2020
Statut: epublish

Résumé

A 47-year-old woman with a history of diabetes mellitus (DM) and obesity was admitted to our hospital for glucose control. She was detected to have hypertension (HT) and diagnosed with primary aldosteronism (PA) based on the high level of aldosterone to renin ratio and the results of the upright furosemide-loading test according to the criteria of the Japanese Society of Hypertension (JSH) guidelines. Computed tomography revealed left renal tumor and adrenocortical adenoma. She underwent left nephrectomy and adrenalectomy. The pathological findings were clear-cell renal cell carcinoma (RCC) and nonfunctional adrenocortical adenoma. Her nonneoplastic adrenal tissue histologically revealed CYP11B2-positive multiple adrenocortical micronodules (MNs) and concomitant paradoxical hyperplasia of the zona glomerulosa. Therefore, MNs were thought to be responsible for PA in this patient. After surgery, HT was improved, and the result of upright furosemide-loading test after 12 months of surgery did not fulfill the criteria of PA according to the JSH guidelines. However, the adrenocorticotrophic hormone stimulation test was positive; considering the possibility of slight aldosterone overproduction from the right adrenal gland, the administration of spironolactone was started. Herein, we report a rare case of RCC in conjunction with PA histologically associated with MNs.

Identifiants

pubmed: 32158565
doi: 10.1155/2020/2808101
pmc: PMC7060454
doi:

Types de publication

Case Reports

Langues

eng

Pagination

2808101

Informations de copyright

Copyright © 2020 Kazuhito Oba et al.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to declare.

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Auteurs

Kazuhito Oba (K)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Yuko Chiba (Y)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Yoko Matsuda (Y)

Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.

Takeshi Kumakawa (T)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Rie Aoyama (R)

Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.

Miho Akahoshi (M)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Seiji Hashimoto (S)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Aya Tachibana (A)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Koichi Toyoshima (K)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Remi Kodera (R)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Kenji Toyoshima (K)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Yoshiaki Tamura (Y)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Takashi Nagata (T)

Department of Urology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.

Yuto Yamazaki (Y)

Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Hironobu Sasano (H)

Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Atsushi Araki (A)

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

Classifications MeSH