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BMJ Case Rep ; 13(9)2020 Sep 09.
Article in English | MEDLINE | ID: mdl-32912887

ABSTRACT

Adrenocortical carcinomas (ACCs) are rare malignancies with an incidence of one to two per million per year. Aldosterone-producing ACCs (APACs) are extremely rare with an incidence less than 1%. We describe a rare case of APAC, presenting with episodic lower-limb weakness and hypertension. Our patient was found to have serum aldosterone levels of 20.8 ng/dL (2.5-15.2) with persistent hypokalaemia and a 9.7×8.3×7.7 cm right adrenal mass, which was suspicious of malignancy on evaluation. He underwent a complete surgical resection which confirmed the diagnosis of ACC and normalised his aldosterone and potassium levels. He was then subjected to postoperative chemotherapy. Postoperative adjuvant chemotherapy with mitotane has a role in preventing recurrence.


Subject(s)
Adrenal Cortex Neoplasms , Adrenalectomy/methods , Adrenocortical Carcinoma , Aldosterone/blood , Hypertension , Hypokalemic Periodic Paralysis , Adrenal Cortex/diagnostic imaging , Adrenal Cortex/pathology , Adrenal Cortex Neoplasms/metabolism , Adrenal Cortex Neoplasms/pathology , Adrenal Cortex Neoplasms/physiopathology , Adrenocortical Carcinoma/metabolism , Adrenocortical Carcinoma/pathology , Adrenocortical Carcinoma/physiopathology , Adult , Chemotherapy, Adjuvant/methods , Diagnosis, Differential , Humans , Hypertension/diagnosis , Hypertension/etiology , Hypokalemic Periodic Paralysis/diagnosis , Hypokalemic Periodic Paralysis/etiology , Male , Potassium/blood , Tomography, X-Ray Computed/methods , Treatment Outcome
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