The concomitance of renal artery stenosis and Conn's adenoma in a hypertensive woman

A case of adrenal aldosterone-secreting adenoma concomitant with active renal artery stenosis in a hypertensive middle-aged woman is reported. The concomitance of the two lesions was previously reported in the literature only in five more reports, that are mentioned and commented here. This association is thought to be almost anecdotal, but some remarks must be done in order to rule out the risk of leaving an ignored lesion at the time of the definitive treatment. The widespread use of noninvasive imaging techniques is effective to find unsuspected adrenal adenoma in the presence of renovascular hypertensive disease, whereas unknown renal artery stenosis can be revealed by more aggressive diagnostic attitude, that is justified only in well selected cases of Conn's disease.