Pathways and dead ends in the diagnostics of primary aldosteronism
Abstract
We present a patient with a tumour of the left adrenal gland who has been treated for resistant hypertension and hypokalaemia for years. Primary aldosteronism was confirmed but despite multiple attempts of adrenal vein sampling we were unable to prove unilateral disease. Treatment with mineralocorticoid receptor antagonists was not successful, however no clear indication for operative treatment was present. Patient's clinical and laboratory characteristics pointed to unilateral disease, so he was referred for PET CT with 11-C-metomidate in the United Kingdom. Unilateral disease was confirmed, and the patient was cured with left-sided laparoscopic adrenalectomy.
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