[Conn's syndrome: surgical experience].

BACKGROUND

Primary aldosteronism is a syndrome clinically characterized by systemic arterial hypertension and hypokalemia that occurs most frequently as a consequence of the excessive production of aldosterone by adrenal cortical hyperplasia or a functioning tumor. Surgical resection of the tumor leads to cure of the disease in most patients. The aim of this study was to analyze a series of patients with an adrenal aldosterone-producing tumor.

PATIENTS AND METHODS

Clinical records of 13 patients with Conn syndrome were reviewed analyzing the clinical presentation, diagnosis, localizing techniques, treatment and follow-up with emphasis in the postoperative outcome of hypertension and serum potassium.

RESULTS

From a total of 105 patients who underwent adrenalectomy in a 12-year period (August 1991-February 2003), 13 patients were operated on to remove an adrenal aldosterone-producing tumor. Mean age was of 43 +/- 11 years, 8 were women and 5 men. All presented with arterial hypertension and 11 also had hypokalemia. Diagnosis of Conn syndrome was established by laboratory tests and an adrenal tumor was found by image studies in all patients. Open adrenalectomy was performed in 2 patients and 11 underwent a laparoscopic procedure. There was neither surgical morbidity nor mortality. The histological analysis established the diagnosis of adenoma in 12 patients and carcinoma in 1. Mean postoperative hospital stay was 3.1 days. A total of 12 patients became normotensive after surgery and potassium levels returned to normal in all cases.

CONCLUSIONS

Conn syndrome was present in 12% of patients undergoing adrenal surgery. Arterial hypertension, low plasma renin activity levels, and hypokalemia were present in all patients. Image studies were able to localize the tumor in all cases and surgical resection of the tumor lead to normal arterial blood pressure in 92% of the patients and eukalemia in 100%.