Health  Vol.1 No.4 , December 2009
Aldosteronoma causing Conn’s syndrome: a case report and literature review
Abstract: We report a case of primary aldosteronism caused by bilateral solitary aldosteronomas occurring 6 months apart, the diagnosis being confirmed by clinical features. Multiple aldos-terone-producing adenomas can be unilateral or bilateral. If bilateral, most of them are found simultaneously. Bilateral solitary aldosterono-mas occurring at separate times are rarely re-ported and the pathogenesis is still elusive. We believe, from this case, the postoperative fol-low-up in patients with primary aldosteronism is mandatory.
Cite this paper: nullShao, H. , Eng, H. , Huang, W. and Lin, J. (2009) Aldosteronoma causing Conn’s syndrome: a case report and literature review. Health, 1, 269-273. doi: 10.4236/health.2009.14043.

[1]   Conn, J.W. and Louis, L.H. (1956) Primary aldostero-nism: A new clinical entity. Ann Intern Med, 44, 1-15.

[2]   Lo, Y.C., Tam, P.C., Kung, A.W., Lam, K.S., and Wong, J. (1996) Primary aldosteronism results of surgical treat-ment. Ann Surg, 224, 125-130.

[3]   Bravo, E.L., Tarazi, R.C., Dustan, H.P., et al. (1983) The changing clinical spectrum of primary aldosteronism. Am J Med, 74, 641-651.

[4]   Phillips, J.L., Walther, M.M., Pezzullo, J.C., et al. (2003) Predictive value of preoperative tests in discriminating bilateral adrenal hyperplasia from an aldosterone-producing adrenal adenoma. J Clin Endocrinol Metab, 85, 4526- 4533.

[5]   Mortensen, R.M. and Williams, G.H. (2001) Aldosterone action. In: DeGroot, L.J. and Jameson, J.L. eds. Endo-crinology, Philadelphia: W.B. Saunders, Forth Edition, 1783-1790.

[6]   Melby, J.C. (1991) Diagnosis of hyperaldosteronism. Endocrinol Metab Clin North Am, 20, 247-255.

[7]   Ito, Y., Fujimoto, Y., Obara, T., and Kodama, T. (1990) Clinical significance of associated nodular lesions of the adrenal in patients with aldosteronoma. World J Surg, 14, 330-334.

[8]   Liu, D., Chen, Q., and Zheng, C. (1995) Evaluation of surgical treatment for patients with multiple aldosteronoma: Analyses of 11 cases. China Surgery, 33, 681-683.

[9]   Engel, J.D., Angelos, P., Rege, R.V., and Joehl, R.J. (1998) Bilateral adrenal cortical adenomas in primary hyperal-dosteronism. Urology, 52, 711-714.

[10]   Yamamoto, H., Sato, T., and Kato, Y. (1993) A rare case of primary aldosteronism due to bilateral functioning adreno-cortical adenomas. Nippon Naibunpi Gakkai Zasshi, 69, 125-134.

[11]   Calvo-Romero, J.M. and Ramos-Salado, J.L. (2000) Re-currence of adrenal aldosterone-producing adenoma. Postgrad Med J, 76, 160-161.

[12]   Auda, S.P., Brennan, M.F., and Gill, J.R. (1980) Evolution of the surgical management of primary aldosteronism. Ann Surg, 191, 1-7.

[13]   Fontes, R.G., Kater, C.E., Biglieri, E.G., and Irony, I. (1991) Reassessment of the predictive value of the postural stimulation test in primary aldosteronism. Am J Hyper-tens, 4, 786-791.

[14]   Ganguly, A., Dowdy, A.J., Luetscher, J.A., and Melada, G.A. (1973) Anomalous postural response of plasma al-dosterone concentration in patients with aldosterone- producing adrenal adenoma. J Clin Endocrinol Metab, 36, 401-404.

[15]   Lumachi, F., Marzola, M.C., Zucchetta, P., et al. (2003) Non-Invasive adrenal imaging in primary aldosteronism: Sensitivity and positive predictive value of radiocholes-terol scintigraphy, CT scan and MRI. Nucl Med Commun, 24, 683-688.

[16]   Lingam, R.K., Sohaib, S.A., Vlahos, I., et al. (2003) CT of primary hyperaldosteronism (Conn’s syndrome): The value of measuring the adrenal gland. Am J Roentgenol, 181, 843-849.

[17]   Young, W.F. and Klee, G.G. (1988) Primary aldostero-nism: Diagnostic evaluation. Endocrinol Metab Clin North Am, 17, 367-395.

[18]   Williams, G.H. and Dluhy, R.G. (2001) Disorders of the adrenal cortex. In: Braunwald, E., Fauci, A.S., Kasper, D.L., Hauser Longo, D.L., Jameson, J.L. eds. Harrison’s Principles of Internal Medicine, New York: McGraw- Hill., Fifteenth Edition, 2084-2105.

[19]   Lieberman, L.M., Beierwaltes, W.H., Conn, J.W., Ansari, A.N., and Nishiyama, H. (1971) Diagnosis of adrenal disease by visualization of human adrenal glands with 131 I-19-iodocholesterol. N Engl J Med, 285, 1387-1393.

[20]   Freitas, J.E., Grekin, R.J., Thrall, J.H., Gross, M.D., Swanson, D.P., and Beierwaltes, W.H. (1979) Adrenal imaging with iodomethyl-norcholesterol (I-131) in pri-mary aldosteronism. J Nucl Med, 20, 7-10.

[21]   Taillefer, R., Soucy, J.P., Eybalin, M.C., and Levasseur, A. (1983) 131I-iodocholesterol (NP-59) scintigraphy in adrenocortical diseases. J Can Assoc Radiol, 34, 120-124.

[22]   Ou, Y.C., Yang, C.R., Chang, C.L., Hwang, T.I., Chang, C.H., Wu, H.C., Ho, Y.J., and Kao, C.H. (1994) Compari-son of five modalities in localization of primary aldos-teronism. Chinese Medical Journal (Taipei), 53, 7-12.

[23]   Dluhy, R.G. and Lifton, R.P. (1994) Glucocorticoid- remediable aldosteronism. Endocrinol Metab Clin North Am, 23, 285-297.

[24]   Litchfield, W.R., New, M.I., Coolidge, C., Lifton, R.P., and Dluhy, R.G. (1997) Evaluation of the dexamethasone sup-pression test for the diagnosis of glucocorticoid-remediable aldosteronism. J Clin Endocrinol Metab, 82, 3570-3573.

[25]   Blumenfeld, J.D., Sealey, J.E., Schlussel, Y., et al. (1994) Diagnosis and treatment of primary hyperaldosteronism. Ann Intern Med, 121, 877-885.

[26]   Obara, T., Ito, Y., Okamoto, T., et al. (1992) Risk factors associated with postoperative persistent hypertension in patients with primary aldosteronism. Surgery, 112, 987- 993.

[27]   Iwase, K., Nagasaka, A., Tsujimura, T., et al. (1994) Cush-ing’s syndrome with cortisol hypersecretion from one of bilateral adrenocortical adenomas: Report of a case. Surg Today, 24, 538-543.

[28]   Skogseid, B., Larsson, C., Lindgren, P.G., et al. (1992) Clinical and genetic features of adrenocortical lesions in multiple endocrine neoplasia type 1. J Clin Endocrinol Metab, 75, 76-81.

[29]   Zwermann, O., Beuschlein, F., Mora, P., Weber, G., Allo-lio, B., and Reincke, M. (2000) Multiple endocrine neo-plasia type 1 gene expression is normal in sporadic adrenocortical tumors. Eur J Endocrinol, 142, 689-95.

[30]   Vircburger, M.I., Prelevic, G.M., Todorovic, P., Bojic, P., Peric, L.A., and Paunkovic, N. (1984) Renovascular hy-pertension associated with bilateral aldosteronoma. Post-grad Med J, 60, 533-536.

[31]   Marchesa, P., Fazio, V.W., Church, J.M., and McGannon, E. (1997) Adrenal masses in patients with familial ade-nomatous polyposis. Dis Colon Rectum, 4, 1023-1028.

[32]   Alexander, G.L., Thompson, G.B., and Schwartz, D. (2000) Primary aldosteronism in a patient with familial adeno-matous polyposis. Mayo Clin Proc, 75, 636-637.