Rojas BL, Morales MJG, Moreno PM, Ariza VP, Andrade PJD, Pacheco GC, Calderón FF

Language: Spanish
References: 7
Page: 197-201
PDF size: 81.49 Kb.

ABSTRACT

Background. The suprarenal adenomas constitute 36% of incidentalomas, they produce cortisol in 5-15% of cases, and produce aldosterone in 1.5-3.5% but rarely they present both characteristics at the same time. Case report. We present the case of a 56 years old woman, with high blood presure managed with beta-blockers, without improvement, she presents frontal headaches, muscular weakness, facial edema and of pelvic members. Diabetes mellitus of recent diagnosis. She goes to urgencies, with glucemia of 521 mg/dL, blood presure 180/110, laboratories with hypokalemia, hypernatremia, metabolic alkalosis. With clinical signs of Cushing’s syndrome. Study begins with the diagnoses of Cushing’s syndrome and primary hyperaldosteronism. After a wide study she undergoes laparoscopic adrenalectomy. The clinical diagnosis was a functional left adrenal tumor producing cortisol and aldosterone. Results. The pathological report was functional suprarenal cortex adenoma. Discussion. All those masses larger than 4 cm have surgical indication; it is feasible to carry out laparoscopic suprarenalectomy in masses larger than 6 cm, although most technical difficulties exist during surgery.

REFERENCES

1. Barzon L, Boscaro M. Diagnosis and management of adrenal incidentalomas. J Urol 2000; 163(2); 398-407.

2. Cambell’s Urology, 7th ed. 1998 Chapter 101.

3. Vaughan ED. Diseases of adrenal gland. Med Clin NA 2004; 88(2).

4. Quinn WF, Hogan MJ, Klee GG, et al. Primary aldosteronism: Diagnosis and treatment. Mayo Clin Proc 1990; 65: 101-10.

5. Melby J. Primary aldosteronism. Kidney Int 1984; 26: 769-78.

6. Bentrem JD, Pappas GS, et al. Contemporary surgical management of phechromocytoma. Am J Sur 2002; 184(6).

7. Sippel SR, Chen H. Subclinical Cushing’s syndrome in adrenal incidentalotas. Surg Clin North Am 2004; 84(3).