Abma E M, Kluin P M, Dullaart R P F
Department of Endocrinology, University Medical Center Hospital Groningen, University of Groningen, Groningen, The Netherlands.
Neth J Med. 2008 Jun;66(6):252-5.
We describe a case of hypokalaemic hypertension due to hyperaldosteronism caused by a unilateral adrenocortical tumour with unfavourable histopathology suggestive of malignancy. After removal, the aldosterone excess disappeared. The patient's clinical course was uneventful, until she presented with extensive metastases of adrenal carcinoma four years later. Biochemical abnormalities were now consistent with glucocorticoid excess without hyperaldosteronism. She died four months later. Although malignant aldosterone-producing adrenal tumours are very rare, the present case underscores that clinicians should be aware that primary hyperaldosteronism can occur in the context of adrenocortical carcinoma.
我们描述了一例因单侧肾上腺皮质肿瘤导致醛固酮增多症引起的低钾血症性高血压病例，该肿瘤组织病理学表现不佳提示为恶性。切除肿瘤后，醛固酮增多的情况消失。患者的临床过程平稳，直到四年后出现肾上腺皮质癌广泛转移。此时生化异常符合糖皮质激素过多但无醛固酮增多症的情况。她在四个月后去世。尽管产生醛固酮的恶性肾上腺肿瘤非常罕见，但本病例强调临床医生应意识到原发性醛固酮增多症可发生于肾上腺皮质癌的背景下。
