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Adrenal cortical carcinoma may present solely with a syndrome of mineralocorticoid excess. Primary aldosteronism, resulting from adrenal carcinoma, is unusual and has only been reported rarely. A review of the literature revealed 19 cases with marked hypertension and hypokalemia, resulting from mineralocorticoid excess produced by adrenal cortical carcinoma. We report an additional case that supports the hypothesis that adrenal carcinoma may mimic hyperaldosteronism. Extensive assay of adrenal function will demonstrate the presence of biologically inactive steroids, suggesting the presence of adrenal cortical carcinoma.

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