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Clinical diagnosis and treatment of a patient with hypertension, hypokalemia, and bilateral adrenal adenomas

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机构： [1]Department of Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. [2]Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. [3]Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China. [4]Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. [5]Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

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关键词： bilateral aldosterone-producing adenomas subtyping diagnosis 68 Ga-Pentixafor PET/MR CYP11B2 bilateral partial adrenalectomy

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Aldosterone-producing adenoma (APA) is one of the main types of primary aldosteronism (PA). APAs are predominantly unilateral, whereas bilateral APAs are rare. Currently, clinical experience in the diagnosis and treatment of bilateral APAs is limited, posing significant challenges. This article reports the case of a PA patient with bilateral adrenal nodules. Adrenal venous sampling (AVS) revealed no dominant lateral secretion, but 68Ga-Pentixafor PET/MR imaging, which targets CXCR4, revealed bilateral positive lesions. The patient achieved biochemical and clinical remission after undergoing bilateral partial adrenalectomy, and CYP11B2 immunohistochemical staining confirmed that both nodules were APAs. This case report suggests that 68Ga-Pentixafor nuclear imaging, which targets CXCR4, is a noninvasive and reliable method for PA subtyping and may be the optimal method for the definitive diagnosis of bilateral APA. Bilateral partial adrenalectomy may be an effective and safe surgical procedure for the treatment of bilateral APAs. This study provides new insights and considerations for clinicians in the diagnosis and treatment of bilateral APAs.Copyright © 2025 Zhang, Chen, Zhang, Tan, Li, Zhu and Ren.

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出版当年[2025]版：

大类 | 3 区医学

小类 | 3 区内分泌学与代谢

最新[2025]版：

大类 | 3 区医学

小类 | 3 区内分泌学与代谢

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第一作者机构： [1]Department of Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

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