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[Mixed corticomedullary tumor]
I Delèvaux1, J Cabane, O Picard
1Service de Médecine interne, Hôpital Saint-Antonie, Paris.
Background:
Pheochromocytoma and primary hyperaldosteronism rarely occur simultaneously. Few cases have been reported in the literature.
Case Report:
A patient explored for hypertension was found to have hypokalemia related to primary hyperaldosteronism. Pathology examination of the ablated adrenal showed a co-existing pheochromocytoma suspected at history taking although urine catecholamines were normal.
Discussion:
Different pathogenic hypothesis have been proposed. Such dual tumors could be a simple coincidence, occur in a particular genetic setting, be related to direct contact between cortical and medullary tissue leading to reactional cortical hyperplasia, pheochromocytoma produced factors stimulating aldosterone synthesis, or factor X, a substance produced by cortical adenomas and favoring growth of the pheochromocytoma.