Aldosterone-Producing Adrenal Cortical Cancer: A Case Report and Analysis of Steroidogenic Enzymes in the Tumor.

Abstract

Abstract.A case of hyperaldosteronism caused by adrenal cortical cancer observed in a 32-year-old man was reported.The patient showed marked hypertension and hypokalemia, but neither obesity nor hyperglycemia was observed. Endocrine studies revealed hyperaldosteronism and concurrent excessive secretion of cortisol, but diurnal rhythms of plasma ACTH and cortisol were normal.Imaging studies revealed a large left adrenal mass, and the positive accumulation of radiolabelled material by adrenal scintigraphy was observed both in the tumor and the contralateral adrenal gland. The removed tumor was predominantly composed of dark compact cells with marked nuclear pleomorphism, and mitotic figures and sinusoidal invasion were also observed. The analysis of steroidogenic enzyme activities revealed that the activity of aldosterone-synthesizing enzyme (P-450aldo) which was usually undetectable in normal adrenal tissues and adenomas other than aldosterone-producing adenoma (APA) was detectable as one-third of that of APA. Although activities of other enzymes were reduced, the expression of P-450aldo activity was considered to be the specific character of this cancer.

Primary Aldosteronism due to Unilateral Adrenal Hyperplasia. Report of Two Cases and Review of the Literature.

“…Aldosterone-producing adrenal cancer and familiar glucocorticoid-remediable hyperaldosteronism have been described as less common subsets [1][2][3]. While unilateral adrenal hyperplasia (UAH) is considered a distinct surgically correctable subset of PA, it is quite rare, and less than 20 cases have been reported [4][5][6][7][8][9][10][11][12][13][14][15][16].…”