Primary aldosteronism with aldosterone-producing adenoma consisting of pure zona glomerulosa-type cells in a pregnant woman.

Abstract

Aldosterone-producing adenoma (APA) consisting of pure zona glomerulosa (ZG)-type cells is extremely rare, and primary aldosteronism complicated by pregnancy is also rare. We report a case of APA discovered in a 32-year-old pregnant woman who visited our hospital for hypertension and hypokalemia at 26 weeks gestation. Elevated plasma aldosterone concentration and hypokalemia were observed, and an magnetic resonance imaging scan demonstrated a right adrenal mass. A laparoscopic adrenalectomy was performed because of refractory hypokalemia. Pathologically, the adrenal mass was diagnosed as APA, and in addition to the cytological features, in situ hybridization and real-time polymerase chain reaction proved that all the component cells were ZG-type cells. The cells also showed estrogen receptor beta immunoreactivity and melanocortin 2 receptor mRNA expression, suggesting that estrogen and/or ACTH might be related to the proliferation of APA cells during pregnancy. Our case is the first report of APA consisting of ZG-type cells discovered during pregnancy.

• Authors: Kazuto Shigematsu, Noriyuki Nishida, Hideki Sakai, Tsukasa Igawa, Shin Suzuki, Kioko Kawai, Osamu Takahara
• Journal: Endocrine pathology (Endocr Pathol) Vol. 20 Issue 1 Pg. 66-72 ( 2009) ISSN: 1046-3976 [Print] United States
• PMID: 19199080 (Publication Type: Case Reports, Journal Article)

Chemical References

• Estrogen Receptor beta
• RNA, Messenger
• Receptor, Melanocortin, Type 2
• Aldosterone

Topics

• Adrenal Cortex Neoplasms (complications, metabolism, pathology)
• Adrenalectomy
• Adrenocortical Adenoma (complications, metabolism, pathology)
• Adult
• Aldosterone (blood)
• Estrogen Receptor beta (biosynthesis)
• Female
• Humans
• Hyperaldosteronism (etiology, pathology)
• Hypertension (etiology)
• Hypokalemia (etiology)
• Immunohistochemistry
• In Situ Hybridization
• Pregnancy
• Pregnancy Complications (metabolism, pathology)
• RNA, Messenger (analysis)
• Receptor, Melanocortin, Type 2 (biosynthesis)
• Reverse Transcriptase Polymerase Chain Reaction
• Zona Glomerulosa (metabolism, pathology)