Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Sep 27:31:60.
doi: 10.11604/pamj.2018.31.60.16973. eCollection 2018.

[Corticosurrenaloma: an exceptional cause of primary hyperaldosteronism]

[Article in French]
Baha Zantour  1 , Ines Charrada  1 , Zohra Elati  1 , Fatma Larbi Ammari  1 , Fadia Boubaker  1 , Sondes Arfa  1 , Olfa Berriche  1 , Wafa Alaya  1 , Mohamed Habib Sfar  1
Affiliations
Case Reports

[Corticosurrenaloma: an exceptional cause of primary hyperaldosteronism]

[Article in French]
Baha Zantour et al. Pan Afr Med J. .

Abstract
in English, French

Corticosurrenaloma is a rare malignant tumor of the adrenal gland that often secretes corticosteroids, sex steroids and precursors. Aldosterone-producing corticosurrenaloma is very rare, accounting for 1 case/10million inhabitants. We report the case of a 38-year old man presenting with severe arterial hypertension associated with deep hypokalaemia (2.2 mmol/L). Exploration showed primary hyperaldosteronism (aldosterone = 2645 pmol/l, aldosterone/renin ratio = 327 pmol/MUI), with hypersecretion of glucocorticoids. Abdominopelvic CT scan revealed left poorly differentiated and heterogeneous adrenal mass measuring 9cm, infiltrating into the surrounding adipose tissue and the diaphragm, extending into the left renal vein, with regional adenopathy and hepatic nodule measuring 4cm. The patient underwent radical nephrectomy followed by right hepatectomy two months after resulting in remission. A year after the patient developed lung metastases. This study highlights that corticosurrenaloma should be suspected in patients with primary aldosteronism despite its rarity.

Le corticosurrénalome est une tumeur maligne rare de la cortico-surrénale. Il secrète souvent des corticostéroïdes, des stéroïdes sexuels et des précurseurs. Le corticosurrénalome producteur d'aldostérone est très rare, 1cas/10 millions d'habitants. Nous rapportons l'observation d'un homme de 38 ans se présentant pour hypertension artérielle sévère associée à une hypokaliémie profonde (2.2 mmol/l). L'exploration a conclu à un hyperaldostéronisme primaire (aldostérone = 2645pmol/l, rapport aldostérone/rénine = 327pmol/mUI), avec hypersécrétion de glucocorticoïdes. Le scanner abdomino-pelvien a montré une masse surrénalienne gauche de 9cm, mal limitée et hétérogène, infiltrant la graisse autour et le diaphragme, envahissant la veine rénale gauche, avec adénopathie régionale et nodule hépatique de 4 cm. Le patient a eu une néphrectomie élargie, suivie d'une hépatectomie droite deux mois après entrainant une rémission. Un an après le patient a développé des métastases pulmonaires. Nous concluons que l'hyperaldostéronisme primaire peut être un mode de révélation du corticosurrénalome, on devra y penser malgré son caractère exceptionnel.

Keywords: Malignant corticosurrenaloma; adrenal; primary hyperaldosteronism.

PubMed Disclaimer

Conflict of interest statement

Les auteurs ne déclarent aucun conflit d'intérêts.

Figures

Figure 1
Figure 1
TDM abdominale: coupe transversale: corticosurrénalome gauche de 9 cm; les flèches montrent les calcifications et les nécroses
Figure 2
Figure 2
TDM abdominale: coupe sagittale de la tumeur
Figure 3
Figure 3
TDM abdominale: métastase hépatique droite de 4 cm
See this image and copyright information in PMC

References

    1. Allolio B, Fassnacht M. Adrenocortical Carcinoma: clinical update. J Clin Endocrinol Metab. 2006 Jun;91(6):2027–37. Epub 2006 Mar 21. - PubMed
    1. Seccia TM, Fassina A, Nussdorfer GG, Pessina AC, et al. Aldosterone-producing adrenocortical carcinoma: an unusual cause of Conn's syndrome with an ominous clinical course. Endocr Relat Cancer. 2005 Mar;12(1):149–159. - PubMed
    1. Weingartner K, Gerharz EW, Bittinger A, Rosai J. Isolated clinical syndrome of primary aldosteronism in a patient with adrenocortical carcinoma. Urol Int. 1995;55(4):232–235. - PubMed
    1. Funder JW, Carey RM, Mantero F, Murad MH, et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016 May;101(5):1889–1916. - PubMed
    1. Fassnacht M, Johanssen S, Quinkler M, Bucsky P, et al. Limited prognostic value of the 2004 International Union Against Cancer staging classification for adrenocortical carcinoma: proposal for a Revised TNM Classification. Cancer. 2009 Jan;115(2):243–250. - PubMed

Publication types