A case of aldosteronism caused by a carcinoma of the adrenal cortex is presented.
Plasma renin activity was determined and found to be suppressed. T e n other reported cases of hypermineralocorticism due to primary carcinoma of the adrenal are summarized, and a comparison of the common features is made.
Excessive production of 17-hydroxycorticoids and/or 17-ketosteroids was present in most of these patients, but there was very little clinical evidence of the effects of hypercortisolism or hyperandrogenia.
O N N ~ FIRST DELINEATED THE CLINICAL SYN-
C drome of aldosteronism in 1955. T h e clinical manifestations of aldosteronism may range from asymptomatic "essential" hypertension to the incapacitating symptoms of severe potassium depletion, i.e., periodic muscular weakness and/or paralysis, interrnittent tetany, paresthesia, headache, polyuria, nocturia, and polydipsia. Although serum electrolytes may be within the normal range,Q most reported cases have demonstrated a hypokalemic alkalosis. Hypertension is a consistent feature of this syndrome.
T h e majority of cases of primary adolsteronsim have been caused by benign adrenocortical adenomata; most ol these patients have been cured by removal of their tumor.8 Malignancy is a very rare cause of primary aldosteronism, as defined by Conn. However, several cases of adrenocortical malignancy manifesting a clinical syndrome caused by the excessive production of aldosterone have been documented. Here we report a case of carcinoma of the adrenal cortex causing welldocumented aldosteronism, and we compare this case with other reported cases of hypermineralocorticism due to carcinoma of the adrenal gland.
From the Department of Medicine, Mount Sinai