Ghilardi G, Pizzocari P, Bortolani E, De Monti M, Longhi F
Istituto di Chirurgia Generale e Cardiovascolare, Università di Milano, Italy.
Panminerva Med. 1991 Jan-Mar;33(1):53-6.
A case of adrenal aldosterone-secreting adenoma concomitant with active renal artery stenosis in a hypertensive middle-aged woman is reported. The concomitance of the two lesions was previously reported in the literature only in five more reports, that are mentioned and commented here. This association is thought to be almost anecdotal, but some remarks must be done in order to rule out the risk of leaving an ignored lesion at the time of the definitive treatment. The widespread use of noninvasive imaging techniques is effective to find unsuspected adrenal adenoma in the presence of renovascular hypertensive disease, whereas unknown renal artery stenosis can be revealed by more aggressive diagnostic attitude, that is justified only in well selected cases of Conn's disease.
报告了一例肾上腺醛固酮分泌腺瘤合并活动性肾动脉狭窄的中年高血压女性病例。此前文献中仅另有五篇报道提及了这两种病变的并存情况,在此对其进行介绍和评论。这种关联被认为几乎是罕见的,但必须加以说明,以便在进行确定性治疗时排除遗漏未被发现病变的风险。在存在肾血管性高血压疾病的情况下,广泛使用非侵入性成像技术有助于发现未被怀疑的肾上腺腺瘤,而对于未知的肾动脉狭窄,则可通过更积极的诊断方法揭示,这仅在精心挑选的原发性醛固酮增多症病例中才合理。