Coexistence of bilateral adrenal phaeochromocytoma and idiopathic hyperaldosteronism

The coexistence of phaeochromocytoma and primary aldosteronism is rare. In the four cases reported in the English literature, adrenal gland involvement was unilateral. The case we report is unusual in that both adrenal glands were affected. Our patient was a 63-year-old man who presented with long-standing hypertension and hypokalaemia. Evaluation for secondary hypertension showed biochemical evidence of both phaeochromocytoma and primary aldosteronism. Bilateral adrenal masses were found on imaging studies. Right total and left partial adrenalectomy were performed. Pathological examination revealed bilateral phaeochromocytomas, with cortical findings consistent with mild cortical hyperplasia. Annual biochemical evaluation over a 2-year period has shown no evidence of recurrent disease. To our knowledge, this is the first reported case in the English-language literature of phaeochromocytomas involving both adrenal glands coexisting with hyperaldosteronism.