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JSLS. 2011 Jan-Mar;15(1):100-4. doi: 10.4293/108680811X13071180407230.

Laparoscopic adrenalectomy for bilateral metachronous aldosteronomas.

Author information

1
Department of Surgery, New York Methodist Hospital, Brooklyn, New York 11215, USA.

Abstract

INTRODUCTION:

Primary aldosteronism affects 5% to 13% of patients with hypertension. Idiopathic bilateral hyperplasia (IHA) and unilateral aldosterone-producing adenoma (APA) are the most common types of primary aldosteronism. Bilateral APA is a very rare entity with only a few reports in the literature. We present the case of a patient with metachronous bilateral APA treated with metachronous bilateral total and near total adrenalectomy.

CASE REPORT:

A 66-year-old female was evaluated for hypokalemia and hypertension refractory to medical therapy 2 years after laparoscopic adrenalectomy for right APA. Follow-up abdominal CT scan revealed a new 1.1-cm left adrenal mass. The patient underwent a laparoscopic near total adrenalectomy for her new left adrenal mass. Pathology examination revealed a new APA. The operation and the patient's postoperative course were uneventful. Potassium levels were normalized and her hypertension became well controlled.

CONCLUSION:

APA can present metachronously months to years after adrenalectomy for APA in the contralateral adrenal gland. Laparoscopic adrenalectomy remains the approach of choice for this pathology.

PMID:
21902953
PMCID:
PMC3134682
DOI:
10.4293/108680811X13071180407230
[Indexed for MEDLINE]
Free PMC Article
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