Multiple unilateral adrenal adenomas in a patient with primary hyperaldosteronism.

ABSTRACT

OBJECTIVE: To report a rare case of multiple unilateral adrenal adenomas in which immunohistochemistry results confirmed primary hyperaldosteronism in each of 3 adenomas. METHODS: We present the clinical, laboratory, radiographic, and pathologic findings of a case of multiple unilateral adrenal adenomas. RESULTS: Although multiple nodules in both adrenal glands are fairly common in patients with bilateral hyperplasia, multiple unilateral nodules are extremely rare. A 45-year-old woman with a long-standing history of severe hypertension was found to have biochemical parameters consistent with primary hyperaldosteronism, multiple unilateral adrenal adenomas, and immunohistochemical test results confirming primary hyperaldosteronism arising from each of 3 adrenal nodules (measuring 2.2 x 2.2 cm, 1.7 x 0.7 cm, and 0.5 x 0.5 cm). CONCLUSION: This case illustrates the rare presentation of primary hyperaldosteronism as multiple unilateral adrenal adenomas in which immunohistochemistry results can confirm the suspected preoperative diagnosis as suggested by biochemical and radiographic evidence.