alexa Multiple Sampling from the Central Veins with their Tributaries can Detect Bilateral Hyperaldosteronism with a Cortisol-Producing Adenoma in a Hypertensive Patient
ISSN: 2157-7536

Journal of Steroids & Hormonal Science
Open Access

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Case Report

Multiple Sampling from the Central Veins with their Tributaries can Detect Bilateral Hyperaldosteronism with a Cortisol-Producing Adenoma in a Hypertensive Patient

Ikki Sakuma1, Jun Saito1, Yoko Matsuzawa1, Masao Omura1, Seiji Matsui2, Koshiro Nishimoto3,4, Kuniaki Mukai5 and Tetsuo Nishikawa1*

1 Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama, Japan

2 Department of Radiology, Yokohama Rosai Hospital, Yokohama, Japan

3 Departments of Urology, School of Medicine, Keio University, Tokyo, Japan

4 Department of Urology, Tachikawa Hospital, Tokyo, Japan

5 Department of Biochemistry, School of Medicine, Keio University, Tokyo, Japan

*Corresponding Author:
Tetsuo Nishikawa
Endocrinology and Diabetes Center
Yokohama Rosai Hospital
3211 Kozukue-cho, Kohoku-ku
Yokohama City, Kanagawa 222-0036, Japan
Tel: +81-454748111
Fax: +81-454748323
E-mail: [email protected]

Received date: April 15, 2014; Accepted date: June 11, 2014; Published date: June 18, 2014

Citation: Sakuma I, Saito J, Matsuzawa Y, Omura M, Matsui S, et al. (2014) Multiple Sampling from the Central Veins with their Tributaries can Detect Bilateral Hyperaldosteronism with a Cortisol-Producing Adenoma in a Hypertensive Patient. J Steroids Hormon Sci 5:135. doi:10.4172/2157-7536.1000135

Copyright: © 2014 Sakuma I, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

A 52-year old woman was admitted to our hospital for evaluation of left adrenal incidenataloma. Endocrinological examination showed Cushing’s syndrome (CS) complicated with masked primary aldosteronism (PA). On the other hand, multiple sampling from the central veins and one or two tributaries of the adrenal veins before and after ACTH-stimulation (multiple AVS) clearly revealed bilateral hyperaldosteronism with excess cortisol secretion from the left adrenal. Thus, we diagnosed this case as CS due to left adrenal tumor with bilateral hyperaldosteronism, and left adrenalectomy was done. Immunohistochemical analysis of the removed left adrenal showed cortisol-producing adenoma and multiple aldosterone-producing cell clusters (APCCs) expressing CYP11B2 within the attached adrenal. Bilateral PA is mostly diagnosed as idiopathic hyperaldosteronism (IHA). IHA has not been examined enough pathologically. We first describe here a possible involvement of APCCs inducing hyperaldosteronism in a case of bilateral PA with a cortisol-producing-adenoma.

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