[Clinical analysis of 149 cases of aldosterone-producing adrenal cortical neoplasms]

To evaluate the diagnosis and treatment of aldosterone-producing adrenal cortical neoplasms.

From 1978 to February 2001, 149 patients with aldosterone-producing adrenal cortical neoplasms were diagnosed and treated. Of these patients, 148 had adrenal adenoma and 1 had adrenal cortical carcinoma. The diagnosis was all confirmed by surgery and pathological studies.

The diagnostic specificity of retroperitoneal pneumography, B-ultrasonography and CT scan are 39%, 67% and 95.3% respectively. It was found that there were significant differences of diagnostic specificity between retroperitoneal pneumography and B-ultrasonography, CT scan (chi2 = 23.89, P < 0.05) and there were significant differences between B-ultrasonography and CT scan (chi2 = 32.10, P < 0.05). In all the patients, serum potassium level elevated to normal range within 1 month postoperatively. In 110 cases out of 149, the blood pressure dropped to normal range within two months after surgery.

Appropriate treatment depends on correct qualitative diagnosis and localization of the causative lesion. B-ultrasonography and CT scan play an important role in diagnosis. Surgery is the major treatment, including laparoscopic adrenalectomy. Factors affecting the therapeutic outcome are aging systemic vascular sclerosis and long duration of the disease.