Document Detail


Association of adrenal medullar and cortical nodular hyperplasia: a report of two cases with clinical and morpho-functional considerations.
MedLine Citation:
PMID:  17526953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arterial hypertension of adrenal etiology is mainly attributed to primary hyperaldosteronism. However, subtle expressions of hyperadrenergic or glucocorticoid excess can also generate arterial hypertension. The present report describes two hypertensive patients cataloged as resistant essential hypertensives, in whom adrenal masses were found incidentally, who highlight the need to recognize these tenuous clinical or laboratory presentations. Case 1 was a 50-yr-old female with hyperadrenergic hypertension associated to a left adrenal node, normal cortisol and aldosterone:renin ratio, marginally increased urinary normetanephrine, and a positive 131I MIBG radioisotope scan. Adrenalectomy normalized blood pressure and urinary metanephrines. Pathology showed a hyperplastic adrenal medulla associated to a multinodular cortical hyperplasia. Case 2 was a 62- yr-old female with progressive hypertension, a slight Cushing phenotype, non-suppressible hypercortisolism, normal urinary metanephrines, and bilateral adrenal nodes. Bilateral adrenalectomy and subsequent replacement normalized blood pressure and phenotypic stigmata. Pathology demonstrated bilateral cortical multinodular hyperplasia and medullary hyperplasia. The clinical study in both patients was negative for MEN. The apparently rare association of cortical and medullary lesions presented by both patients is probably overlooked in routine pathology exams, but should be meticulously searched since the crosstalk between the adrenal cortex and medulla may prompt dual abnormalities.
Authors:
Gloria Vald?s; Eric Roessler; Iv?n Salazar; Helmar Rosenberg; Carlos Fardella; Pedro Mart?nez; Alfredo Velasco; Soledad Velasco; Pilar Orellana
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Endocrine     Volume:  30     ISSN:  1355-008X     ISO Abbreviation:  Endocrine     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-05-28     Completed Date:  2007-09-18     Revised Date:  2010-06-24    
Medline Journal Info:
Nlm Unique ID:  9434444     Medline TA:  Endocrine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  389-96     Citation Subset:  IM    
Affiliation:
Departamentos de Nefrolog?a, Anatom?a Patol?gica, Endocrinolog?a, Urolog?a, y Radiolog?a, Facultad de Medicina, Pontificia Universidad Cat?lica de Chile, Santiago, Chile. gvaldes@med.puc.cl
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Diseases / complications*,  diagnosis
Adrenal Gland Neoplasms / complications,  diagnosis
Adrenal Glands / pathology*
Female
Humans
Hyperplasia / complications,  diagnosis
Hypertension / etiology*
Middle Aged
Pheochromocytoma / complications,  diagnosis

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