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Exp Clin Endocrinol Diabetes 2005; 113(4): 236-240
DOI: 10.1055/s-2005-837663
Case Report

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Steroid Profile in an Adrenocortical Carcinoma Producing Aldosterone

K. Müssig1 , M. Wehrmann2 , M. Horger3 , R. Teichmann4 , C. Maser-Gluth5 , H.-U. Häring1 , D. Overkamp1
  • 1Department of Internal Medicine, Division of Endocrinology, Metabolism, and Pathobiochemistry, University Hospital of Tübingen, Germany
  • 2Department of General Pathology, University Hospital of Tübingen, Germany
  • 3Department of Diagnostic Radiology, University Hospital of Tübingen, Germany
  • 4Department of General Surgery, University Hospital of Tübingen, Germany
  • 5Steroid Laboratory, Department of Pharmacology, University of Heidelberg, Germany
Further Information

Publication History

Received: 24. Mai 2004 First decision: 20. September 2004

Accepted: 10. Dezember 2004

Publication Date:
13 May 2005 (online)

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Abstract

We report a rare case of primary aldosteronism due to an adrenocortical carcinoma. A 61-year-old woman with a history of hypertension and hypokalemia was referred for evaluation of a 4.2 cm measuring adrenal mass without secondary signs of malignancy. Endocrinological testing was consistent with primary aldosteronism. The patient underwent surgical resection of the adrenal mass; histology revealed an adrenocortical carcinoma. Postoperatively blood pressure, serum potassium, and aldosterone returned to normal. Four months after adrenalectomy, the patient presented again with hypokalemic hypertension and was found to have metastatic disease. Endocrinological investigation revealed primary aldosteronism and subclinical autonomous glucocorticoid hypersecretion. Careful hormonal investigation should be obtained in patients with adrenal masses causing excessive aldosterone secretion. In uncertain cases of primary aldosteronism, we would suggest to measure 18-hydroxycortisol levels, as excessive amounts may indicate adrenocortical carcinoma.

Key words

Adrenocortical carcinoma - primary aldosteronism - mineralocorticoid hypertension - 18-hydroxycortisol

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Dr. M.D Karsten Müssig

Medizinische Klinik IV
Universitätsklinikum Tübingen

Otfried-Müller-Straße 10

72076 Tübingen

Germany

Phone: + 49(0)70712983670

Fax: + 49 (0) 70 71 29 27 84

Email: karsten.muessig@med.uni-tuebingen.de