Percutaneous Radiofrequency Ablation After Incomplete Adrenalectomy in a Lateralized Case of Primary Aldosteronism

Primary aldosteronism (PA) is a common cause of secondary hypertension. When unilateral aldosterone secretion is identified, surgery is the treatment of choice in most patients and is associated with a high cure rate. Alternative treatments, such as radiofrequency ablation (RFA), are possible options, particularly when surgery is contraindicated. A 56-year-old patient presented with hypertension secondary to PA. A left lateralization was identified after adrenal vein sampling, and the patient underwent a left laparoscopic adrenalectomy. Postoperatively, a residual adrenal remnant was detected incidentally on a computed tomography scan. Persistent PA was confirmed by hormonal workup. To avoid open laparotomy, RFA was proposed as an alternative treatment. The procedure was a biological success, leading to normalization of PA markers. Although adrenalectomy failure is rare, RFA appears to be a possible alternative treatment strategy to prevent the need for repeat surgery and its associated risks.