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肾上腺醛固酮瘤所致原发性醛固酮增多症与肾上腺异位脑膜瘤同时发生:一例报告。

Simultaneous occurrence of primary aldosteronism due to aldosteronoma and ectopic meningioma in the adrenal gland: A case report.

作者信息

Ramlagun Dadhija, Shadhu Kamleshsingh, Sang Miaomiao, Zhu Kai, Qin Chao, Sun Min

机构信息

Department of Urology.

Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University and Jiangsu Province Hospital, Gulou District, Nanjing City, Jiangsu Province, PR China.

出版信息

Medicine (Baltimore). 2018 Dec;97(50):e13591. doi: 10.1097/MD.0000000000013591.

Abstract

RATIONALE

Primary aldosteronism due to aldosteronoma is the most common form of secondary hypertension, with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Diagnosis is a clinical challenge with simultaneous occurrence of primary ectopic meningioma in the adrenal gland. To our knowledge this is the first reported case of simultaneous occurrence of aldosteronomas and ectopic meningioma in the adrenal gland based on literatures.

PATIENT CONCERNS

A 30-year-old man presented with resistant hypertension for one year. The computed tomographic scans were suggestive of left adrenal gland hyperplasia.

INTERVENTION

The patient underwent partial unilateral laparoscopic adrenalectomy.

DIAGNOSIS

The histopathological examination of the resected sample confirmed primary ectopic meningioma in adrenal gland and aldosterone producing adenoma (APA). The saline load test, captopril test, and plasma aldosterone/renin ratio were indicative of primary aldosteronism (PA).

OUTCOMES

The patient had controlled blood pressure postoperatively.

LESSONS

The patient was diagnosed with PA due to APA and nonfunctional primary ectopic meningioma in the adrenal gland which is very rare and dealt with unilateral laparoscopic adrenalectomy.

摘要

原理

由醛固酮瘤引起的原发性醛固酮增多症是继发性高血压最常见的形式,据估计在初级保健中的高血压患者患病率为4%,在转诊患者中约为10%。诊断是一项临床挑战,因为肾上腺同时发生原发性异位脑膜瘤。据我们所知,这是基于文献报道的首例肾上腺同时发生醛固酮瘤和异位脑膜瘤的病例。

患者情况

一名30岁男性因顽固性高血压就诊1年。计算机断层扫描提示左肾上腺增生。

干预措施

患者接受了单侧腹腔镜肾上腺部分切除术。

诊断结果

切除样本的组织病理学检查证实肾上腺原发性异位脑膜瘤和醛固酮分泌腺瘤(APA)。生理盐水负荷试验、卡托普利试验和血浆醛固酮/肾素比值提示原发性醛固酮增多症(PA)。

治疗结果

患者术后血压得到控制。

经验教训

该患者被诊断为因APA和肾上腺无功能性原发性异位脑膜瘤导致的PA,这种情况非常罕见,通过单侧腹腔镜肾上腺切除术进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eec7/6319975/8a36c6b2aa05/medi-97-e13591-g001.jpg

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