J Korean Soc Endocrinol.  2001 Feb;16(1):134-139.

A Case of Adrenalectomy after Preterm Delivery in Cushing's Syndrome of Third Trimester Pregnant Woman

• Song KS
• Hwang JK
• Ju KT
• Lee HJ
• Song SH
• Lee KY
• Suh CJ
• Kim HK
• Park HY
• Yang DM
• Oh YH
• Kang MH

Abstract

A renin- or angiotensin-II responsive aldosterone producing tumor is a rare cause of primary hyperaldosteronism. This tumor can be identified by tests that show that the aldosterone producing adrenal tumor is not fully autonomous. In other words partially it is responsible for the stimulation of aldosterone secretion that results aldosterone levels in an increase in serum in response to the upright posture and spironolactone treatment. Furthermore, the urinary 18-hydroxycortisol level is within the normal range. Because of different responses to surgical removal, the differential diagnosis of the causes of primary aldosteronism can't be overemphasized even for rare causes of primary aldosteronism such as unilateral nodular hyperplasia or a renin-responsible aldosterone producing tumor. We should consider renin or angiotensin-II responsive adrenal adenoma in the differential diagnosis of primary aldosteronism when biochemical data shows atypical results. Here we present the first case in Korea of a renin-responsive aldosterone producing adrenal adenoma which was fully accessible and was successfully treated by surgical removal. Also, sampling for aldosterone secretion just above the insertion site in the left renal vein before surgery showed a suspiciously abberant left adrenal vein drainage into the IVC, This was very helpful information during adrenal vein ligation in laparoscopic adrenalectomy.

MeSH Terms

Adenoma
Adrenalectomy*
Aldosterone
Cushing Syndrome*
Diagnosis, Differential
Drainage
Female
Humans
Hyperaldosteronism
Hyperplasia
Korea
Ligation
Posture
Pregnancy
Pregnancy Trimester, Third*
Pregnant Women*
Reference Values
Renal Veins
Renin
Spironolactone
Veins
Aldosterone
Renin
Spironolactone