Case Report: Adrenocortical carcinoma in an adult male with hypokalemic hypertensive: Report of a rare case in Nepal

Abstract

Adrenocortical carcinoma (ACC), with an incidence of 2-5 percent, is an uncommon source of unilateral adrenal mass and hyperaldosteronism. In Nepal, there is no literature on this uncommon adrenocortical cancer. A forty-year-old Nepalese army regular with resistant hypertension on various antihypertensive medicines presenting with a background of considerable weight loss decreased appetite, and repeated episodes of vomiting were described. His blood tests revealed hypokalemia and a high aldosterone/renin ratio. A tumor in the left adrenal gland was discovered during an abdominal CECT scan. He was operated on for left adrenal incidentaloma and the procedure was uneventful. We recommend clinicians suspect hyperaldosteronism in an adult with refractory hypertension and hypokalemia.

A Rare Case of Adrenal Carcinoma With Isolated Hypercortisolism Mimicking Hyperaldosteronism

“…Patients presenting with hypertension and hypokalemia without signs and symptoms of Cushing’s syndrome are rare. In one case reported in Nepal, a patient with ACC presented with hypertension and hypokalemia, but his tumor was found to be aldosterone-secreting [ 7 ]. Another case report described a patient with an advanced-stage cortisol-secreting ACC who initially presented similarly to our patient, but was later on found to have had vague symptoms of Cushing’s syndrome in the past upon further history-taking [ 8 ].…”