A 52-year-old man was evaluated for incidentally discovered bilateral adrenal masses. He had drugresistant hypertension but lacked Cushingoid features. Endocrinological tests revealed autonomous secretion of cortisol and aldosterone with suppressed plasma ACTH and renin activity. A selective adrenal venous sampling demonstrated aldosterone hypersecretion from the left adrenal vein. The clinical diagnosis of subclinical Cushing's syndrome due to ACTH-independent macronodular adrenal hyperplasia (AIMAH) associated with primary aldosteronism was made, and he underwent left adrenalectomy; the resected adrenal lesion was consistent with the pathological diagnosis of AIMAH coexistent with aldosterone-producing adenoma (APA). This is a very rare case of AIMAH with concomitant unilateral APA, whose hypertension improved after surgery.
- ACTH-independent macronodular adrenal hyperplasia
- Adrenal venous sampling
- Primary aldosteronism
- Subclinical cushing's syndrome
ASJC Scopus subject areas
- Internal Medicine