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JPY
Abstract
We report effective diagnoses and treatments in two cases with adrenal incidentaloma. The first male case aged 38 years was suffered from hypertension and right adrenal incidentaloma(14 cm and 11 cm in diameter)through CT, MRI and PET‒CT, who showed slightly higher levels of adrenaline, noradrenaline and vanilmandelic acid of 24 hour urine, in despite of normal ranges of blood catecholamines. Right adrenal tumor adhered with renal tissue was removed surgically, accompanying with right nephrectomy. Normotension continued postoperatively without any drug. The second female case aged 52 years showed hypertension, hypokalemia(2.5mEq/L), high concentration of plasma aldosterone(400.7 pg/mL, normal range:29.9‒158 pg/mL), hyporeninemia(<0.2 ng/mL/hr), alkalosis and small adrenal adenoma through abdominal CT. Right adenoma with high secretion of aldosteron was confirmed by both selective adrenal venous sampling and adrenal scintigraphy, indicating primary aldosteronism. Right adrenal adenoma was removed by laparoscopic adrenalectomy, resulting in near normotension without drugs involving spironolactone. Furthermore, microscopic findings of adrenal tissues were consist with the above diagnoses in the two cases.
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