ABSTRACT
Tyrosine kinase inhibitors such as sorafenib and axitinib were developed to treat malignancies, including stage IV renal cell carcinoma. Recently, we experienced a patient with pancreatic side effects from both sorafenib and axitinib. We report this case and include a discussion of the literature.
Subject(s)
Antineoplastic Agents/adverse effects , Carcinoma, Renal Cell/drug therapy , Imidazoles/adverse effects , Indazoles/adverse effects , Kidney Neoplasms/drug therapy , Niacinamide/analogs & derivatives , Pancreatitis/diagnosis , Phenylurea Compounds/adverse effects , Antineoplastic Agents/therapeutic use , Axitinib , Carcinoma, Renal Cell/secondary , Humans , Imidazoles/therapeutic use , Indazoles/therapeutic use , Kidney Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Niacinamide/adverse effects , Niacinamide/therapeutic use , Pancreatitis/chemically induced , Phenylurea Compounds/therapeutic use , SorafenibABSTRACT
The case of a patient with primary aldosteronism due to unilateral adrenal hyperplasia (UAH) is reported. A 43-year-old man with an 8-year history of hypertension presented at our institution with hypokalemia, increased plasma aldosterone concentration (PAC), and suppressed plasma renin activity (PRA). An abdominal CT scan showed almost normal adrenal glands with slight enlargement in the left gland. 131I-Norcholesterol adrenal scintigraphy under dexamethasone suppression showed bilaterally decreased uptake. To rule out idiopathic hyperaldosteronism, an adrenal vein sampling before and after ACTH stimulation was performed and a left-sided lateralization of PAC was observed. A left adrenalectomy was performed, and the patient had a good clinical and biochemical response. Micronodular hyperplasia was discovered in the adrenal gland histologically, and in the immunohistochemical analysis, positive staining for 3beta-hydroxysteroid dehydrogenase in micronodular lesions confirmed the diagnosis of UAH. Although UAH is a rare subset of primary aldosteronism, it is surgically correctable as a unilateral autonomous aldosterone-producing lesion. Careful investigations, including bilateral adrenal vein sampling, should be performed for the diagnosis.
