Primary aldosteronism due to adrenal carcinomas

Area of Science:

• Endocrinology
• Oncology
• Nephrology

Background:

• Aldosterone-producing adrenal carcinomas are rare but aggressive tumors.
• Primary aldosteronism presents with hypertension and hypokalemia, often due to benign adenomas.

Purpose of the Study:

• To report on two cases of aldosterone-producing adrenal carcinomas.
• To detail the clinical presentation, hormonal profile, and treatment outcomes.

Main Methods:

• Case report of two patients with adrenal carcinoma.
• Hormonal assays including plasma aldosterone, renin activity, cortisol, and steroid metabolites.
• Surgical intervention (adrenalectomy, lymph node removal) and medical treatment (o,p'-DDD).

Main Results:

• Both patients presented with severe hypertension, hypokalemia, and characteristic hormonal imbalances (high aldosterone, suppressed renin).
• Adrenalectomy provided temporary symptom relief, but disease recurrence occurred due to metastases.
• o,p'-DDD treatment improved hormonal status and clinical condition in one patient.

Conclusions:

• Aldosterone-producing adrenal carcinomas are aggressive and can recur even after surgery.
• Hormonal monitoring is crucial for detecting recurrence and guiding treatment.
• o,p'-DDD may offer a therapeutic option for managing hormonal hypersecretion in advanced cases.