Primary aldosteronism with ipsilateral adrenal cyst: report of a case

Adrenal cysts are rare; most lack endocrinologic activity and do not produce clinical symptoms. The present case is the first to be reported with both an adrenal cyst and a functioning adenoma present ipsilaterally. This 39-year-old male with hypertension was diagnosed as having primary aldosteronism as reflected by hypokalemia and an excess plasma aldosterone concentration (PAC). However, examination by computed tomography revealed a grossly enlarged left adrenal gland with a cyst-like lesion. The right adrenal appeared normal. At surgery, an adenoma and a cyst were found to coexist in the left adrenal cortex. The cyst fluid contained three times the amount of aldosterone present in plasma, less than in previous reports, and was considered to lack endocrinologic activity. Following a left adrenectomy, the patient's blood pressure, serum potassium concentration, and PAC all normalized without the need for medical treatment.