Coexistence of Primary Aldosteronism and Pheochromocytoma in a Vietnamese Patient

Nguyen, HoangʼLan T.; Khanh, Vu

doi:10.1097/00019616-199611000-00011

Cited by 6 publications

(2 citation statements)

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“…Of the 6 patients (40%) who displayed persistent PA postoperatively, 3 were found to have bilateral PA on AVS but underwent unilateral right-sided adrenalectomy to treat their PHEO, logically resulting in persistent PA following surgery; 1 was found to have left-sided PA on AVS but underwent right-sided adrenalectomy to treat his PHEO, logically resulting in persistent PA following surgery; and 2 did not undergo AVS but were found to have persistent PA following unilateral right-sided adrenalectomy to treat their PHEO, suggesting prior left-sided or bilateral aldosterone excess. We also found a number of cases (patients 7, 10, and 15) [ 6 , 8 , 13 ], where PA resolved following an isolated right adrenalectomy to treat their PHEO and/or PA. Additionally, of the 9 patients who underwent AVS, 5 (56%) were diagnosed with bilateral PA and 4 (44%) with left-sided PA, Table 1 . Despite our small sample size, these findings suggest that PA in the setting of concomitant PHEO may present unilaterally or bilaterally without a skewed tendency for one or the other, and regardless of the laterality of the PHEO.…”

Section: Discussionmentioning

confidence: 84%

Concomitant Pheochromocytoma and Primary Aldosteronism: A Case Series and Literature Review

Mao

Baker

Rainey

et al. 2021

Journal of the Endocrine Society

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Context The detection and management of concomitant pheochromocytoma (PHEO) and primary aldosteronism (PA) is not well understood. Objective To investigate varying presentations and outcomes of cases with coexisting PHEO and PA to provide an approach to its diagnosis and management. Design Retrospective case series from 2000-2020; additional review of cases before 2000 and from the medical literature. Setting Single institution tertiary center. Patients Adults with concomitant PHEO and PA. Main Outcome Measures Clinical, biochemical, radiologic, and histologic parameters. Results Fifteen patients (53% men, median age 53 years) were diagnosed with concomitant PHEO and PA. The majority presented with hypertension (13, 87%) and hypokalemia (13, 87%), and 6 (40%) presented with symptoms suggestive of catecholamine excess. All patients who underwent preoperative work-up for catecholamine excess (14, 93%) were found to have biochemical levels above the upper limits of normal. Adrenal vein sampling (AVS) was performed in 9 patients (60%), where 5 (56%) were diagnosed with bilateral PA, and 4 (44%) with unilateral PA. Patients underwent either unilateral (12, 80%) or bilateral (3, 20%) adrenalectomy. Biochemical improvement or resolution of catecholamine excess was confirmed in all cases with documented measurements. Recurrence of PHEO was not observed. Six patients (40%) displayed persistent PA postoperatively. Conclusions Concomitant PHEO and PA is a rare but likely under-reported condition. Hypertension with or without hypokalemia should prompt evaluation for PA, while any indeterminate adrenal mass should be assessed for PHEO. Coexisting disease warrants consideration of AVS to determine the laterality of PA to ensure appropriate management.

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Section: Discussionmentioning

confidence: 84%

Concomitant Pheochromocytoma and Primary Aldosteronism: A Case Series and Literature Review

Mao

Baker

Rainey

et al. 2021

Journal of the Endocrine Society

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“…The simultaneous occurrence of adrenomedullary and adrenocortical tumors is extremely rare. There are only five reported cases in the literature [4]. We have suggested that a local interaction between the adrenocortical and medullary areas may involved.…”

Section: Discussionmentioning

confidence: 86%

Coexistence of the Hypersecretion of Catecholamine, Adrenal Cortical Nodular Hyperplasia, and Nephrotic-Range Proteinuria of Focal Segmental Scleronephrosis: Is It Fat-Induced Hypertension?

Lương¹,

Nguyễn²,

Nguyen³

et al. 2011

IJCM

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Two patients had a long history of hypertension and one of them also had a nephrotic-range proteinuria secondary to focal segmental scleronephrosis which had been diagnosed by kidney biopsy. They presented with uncontrolled hypertension. Laboratory examination suggested hypersecretion of catecholamines by the left adrenal glands in both patients and primary aldosteronism in one of them. A computed tomography scan revealed small nodules on left adrenal gland in both patients. Patients underwent laparoscopic left adrenalectomy. After surgery, blood pressure was normalized and proteinuria was resolved. Most interestingly, prominent adipocytes infiltrated were detected in the adrenal cortex and were associated with the presence of lymphocytes, which suggested that adipocytes might have a role in the pathogenesis of these diseases in our patients

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Pheochromocytoma and sub-clinical Cushing’s syndrome during pregnancy: Diagnosis, medical pre-treatment and cure by laparoscopic unilateral adrenalectomy

Finkenstedt

Gasser

Höfle

et al. 1999

J Endocrinol Invest

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The coexistence of pheochromocytoma and primary adrenal Cushing's syndrome of the same adrenal gland has rarely been reported. We describe here the case of a female patient presenting with mild Cushing's stigmata, hypertension and diabetes mellitus in whom we diagnosed a pheochromocytoma of the left adrenal gland with coexisting non-ACTH-dependent cortisol hypersecretion. While hormonal work-up was still in progress, the patient became pregnant and wanted to carry her pregnancy to full-term. A laparoscopic adrenalectomy in the 17th week of gestation was decided upon and the patient accordingly prepared for surgery by pre-treatment with phenoxybenzamine. Successful surgery--the first ever reported laparoscopic resection of a pheochromocytoma in pregnancy--without perioperative complications was performed under general anesthesia, with the patient receiving peri- and post-operative hydrocortisone substitution. Pathohistological examination revealed a pheochromocytoma with positive immunostaining for interleukin-6 (IL-6) and negative immunostaining for ACTH, vasoactive intestinal polypeptide (VIP) and cytochrome P450, and with no signs of malignancy. A paracrine stimulation of the ipsilateral adrenal cortex by IL-6 produced by the pheochromocytoma, leading to cortical hyperplasia and subclinical Cushing's syndrome, is suggested by the positive immunostaining for IL-6 and the MRI findings. Post-operatively, secondary adrenal insufficiency ensued, necessitating continuing hydrocortisone replacement over 12 months. Hypertension resolved after surgery, and diabetes after the uncomplicated vaginal delivery at term.

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Coexistence of Primary Aldosteronism and Pheochromocytoma in a Vietnamese Patient

Cited by 6 publications

References 0 publications

Concomitant Pheochromocytoma and Primary Aldosteronism: A Case Series and Literature Review

Concomitant Pheochromocytoma and Primary Aldosteronism: A Case Series and Literature Review

Coexistence of the Hypersecretion of Catecholamine, Adrenal Cortical Nodular Hyperplasia, and Nephrotic-Range Proteinuria of Focal Segmental Scleronephrosis: Is It Fat-Induced Hypertension?

Pheochromocytoma and sub-clinical Cushing’s syndrome during pregnancy: Diagnosis, medical pre-treatment and cure by laparoscopic unilateral adrenalectomy

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