Endocrine

, Volume 38, Issue 3, pp 313–319 | Cite as

Primary aldosteronism due to adrenocortical adenoma with concurrent ileum carcinoid tumor: case report

  • L. Zinnamosca
  • L. Petramala
  • D. Cotesta
  • C. Marinelli
  • S. Sciomer
  • G. Cavallaro
  • A. Ciardi
  • R. Massa
  • G. De Toma
  • S. Filetti
  • C. Letizia
Case Report
First Online:

Abstract

Primary aldosteronism (PA) with synchronous carcinoid syndrome is extremely rare occurrence. In this article, we describe a case of PA due to adrenocortical adenoma (“aldosteronoma”) and concurrent malignant carcinoid tumor of ileum. The patient was treated with synchronous right adrenalectomy and resection of the ileum. This case is an example of concomitant presence of two types of tumors, effectively managed surgically. We report a case of a nonclassical form of multiple endocrine neoplasia type 1 (MEN 1) syndrome.

Keywords

Primary aldosteronism Carcinoid syndrome Adrenocortical adenoma 
This is a preview of subscription content, log in to check access.

Notes

Conflict of interest

This study has been realized without governmental funding.

References

  1. 1.
    G.P. Rossi, G. Bernini, C. Caliumi, G. Desideri, B. Fabris, C. Ferri, C. Ganzaroli, G. Giacchetti, C. Letizia, M. Maccario, F. Mallamaci, M. Mannelli, M.J. Mattarello, A. Moretti, G. Palumbo, G. Parenti, E. Porteri, A. Semplicini, D. Rizzoni, E. Rossi, M. Boscaro, A.C. Pessina, F. Mantero, PAPY Study Investigators, A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J. Am. Coll. Cardiol. 48, 2293–2300 (2006)CrossRefPubMedGoogle Scholar
  2. 2.
    L. Mosso, C. Carvajal, A. González, A. Barraza, F. Avila, J. Montero, A. Huete, A. Gederlini, C.E. Fardella, Primary aldosteronism and hypertensive disease. Hypertension 42, 161–165 (2003)CrossRefPubMedGoogle Scholar
  3. 3.
    R.D. Gordon, M. Stowasser, T.J. Tunny, S.A. Klemm, J.C. Rutherford, High incidence of primary aldosteronism in 199 patients referred with hypertension. Clin. Exp. Pharmacol. Physiol. 21, 315–318 (1994)CrossRefPubMedGoogle Scholar
  4. 4.
    K.C. Loh, E.S. Koay, M.C. Khaw, S.C. Emmanuel, W.F. Young Jr, Prevalence of primary aldosteronism among Asian hypertensive patients in Singapore. J. Clin. Endocrinol. Metab. 85, 2854–2859 (2000)CrossRefPubMedGoogle Scholar
  5. 5.
    G.P. Rossi, A.C. Pessina, A.M. Heagerty, Primary aldosteronism: an update on screening, diagnosis and treatment. J. Hypertens. 26, 613–621 (2008)CrossRefPubMedGoogle Scholar
  6. 6.
    H. Abe, K. Kubota, T. Noie, W. Kimura, M. Makuuchi, A rare combination consisting of primary hyperaldosteronism and glucagonoma. Am. J. Gastroenterol. 94, 1397–1401 (1999)CrossRefPubMedGoogle Scholar
  7. 7.
    R.F. Berbarie, M. Emmett, N.A. Breslau, Quiz page. Secondary hypertension with contralateral pheochromocytoma and aldosteronoma. Am. J. Kidney Dis. 46(1), A51, e1-3 (2005)Google Scholar
  8. 8.
    M. Astegiano, F. Bresso, B. Demarchi, N. Sapone, D. Novero, G. Palestro, A. Resegotti, R. Pellicano, M. Rizzetto, Association between Crohn’s disease and Conn’s syndrome. A report of two cases. Panminerva Med. 47, 61–64 (2005)PubMedGoogle Scholar
  9. 9.
    M. Honda, T. Tsukada, T. Horiuchi, R. Tanaka, K. Yamaguchi, T. Obara, H. Miyakawa, T. Yamaji, M. Ishibashi, Primary hyperparathyroidism associated with aldosterone-producing adrenocortical adenoma and breast cancer: relation to MEN1 gene. Intern. Med. 43, 310–314 (2004)CrossRefPubMedGoogle Scholar
  10. 10.
    A. Beckers, R. Abs, P.J. Willems, B. van der Auwera, K. Kovacs, M. Reznik, A. Stevenaert, Aldosterone-secreting adrenal adenoma as part of multiple endocrine neoplasia type 1 (MEN1): loss of heterozygosity for polymorphic chromosome 11 deoxyribonucleic acid markers, including the MEN1 locus. J. Clin. Endocrinol. Metab. 75, 564–570 (1992)CrossRefPubMedGoogle Scholar
  11. 11.
    S.N. Pinchot, K. Holen, R.S. Sippel, H. Chen, Carcinoid tumors. Oncologist 13, 1255–1269 (2008)CrossRefPubMedGoogle Scholar
  12. 12.
    G. Aggarwal, K. Obideen, M. Wehbi, Carcinoid tumors: what should increase our suspicion? Clevel. Clin. J. Med. 75, 849–855 (2008)CrossRefGoogle Scholar
  13. 13.
    J.C. Yao, M. Hassan, A. Phan, C. Dagohoy, C. Leary, J.E. Mares, E.K. Abdalla, J.B. Fleming, J.N. Vauthey, A. Rashid, D.B. Evans, One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J. Clin. Oncol. 26, 3063–3072 (2008)CrossRefPubMedGoogle Scholar
  14. 14.
    I.M. Modlin, K. Oberg, D.C. Chung, R.T. Jensen, W.W. de Herder, R.V. Thakker, M. Caplin, G. Delle Fave, G.A. Kaltsas, E.P. Krenning, S.F. Moss, O. Nilsson, G. Rindi, R. Salazar, P. Ruszniewski, A. Sundin, Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 9, 61–72 (2008)CrossRefPubMedGoogle Scholar
  15. 15.
    B. Eriksson, G. Klöppel, E. Krenning, H. Ahlman, U. Plöckinger, B. Wiedenmann, R. Arnold, C. Auernhammer, M. Körner, G. Rindi, S. Wildi, Frascati Consensus Conference participants. Consensus guidelines for the management of patients with digestive neuroendocrine tumors—well-differentiated jejunal-ileal tumor/carcinoma. Neuroendocrinology 87, 8–19 (2008)CrossRefPubMedGoogle Scholar
  16. 16.
    J.D. Blumenfeld, J.E. Sealey, Y. Schlussel, E.D. Vaughan Jr., T.A. Sos, S.A. Atlas, F.B. Müller, R. Acevedo, S. Ulick, J.H. Laragh, Diagnosis and treatment of primary hyperaldosteronism. Ann. Intern. Med. 121, 877–885 (1994)PubMedGoogle Scholar
  17. 17.
    A. Ganguly, Primary aldosteronism. N. Engl. J. Med. 339, 1828–1834 (1998)CrossRefPubMedGoogle Scholar
  18. 18.
    J.K. Ramage, A.H. Davies, J. Ardill, N. Bax, M. Caplin, A. Grossman, R. Hawkins, A.M. McNicol, N. Reed, R. Sutton, R. Thakker, S. Aylwin, D. Breen, K. Britton, K. Buchanan, P. Corrie, A. Gillams, V. Lewington, D. McCance, K. Meeran, A. Watkinson, UKNETwork for Neuroendocrine Tumours. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut. 54 Suppl 4, iv1-16 (2005)Google Scholar
  19. 19.
    W.W. de Herder, Tumours of the midgut (jejunum, ileum and ascending colon, including carcinoid syndrome). Best Pract. Res. Clin. Gastroenterol. 19, 705–715 (2005)CrossRefPubMedGoogle Scholar
  20. 20.
    E.D. Williams, M. Sandler, The classification of carcinoid tumours. Lancet 1, 238–239 (1963)CrossRefPubMedGoogle Scholar
  21. 21.
    M.A. Maggard, J.B. O’Connell, C.Y. Ko, Updated population-based review of carcinoid tumors. Ann. Surg. 240, 117–122 (2004)CrossRefPubMedGoogle Scholar
  22. 22.
    I.M. Modlin, M. Kidd, I. Latich, M.N. Zikusoka, M.D. Shapiro, Current status of gastrointestinal carcinoids. Gastroenterology 128, 1717–1751 (2005)CrossRefPubMedGoogle Scholar
  23. 23.
    A.N. van der Horst-Schrivers, A.N. Wymenga, T.P. Links, P.H. Willemse, I.P. Kema, E.G. de Vries, Complications of midgut carcinoid tumors and carcinoid syndrome. Neuroendocrinology 80, 28–32 (2004)CrossRefPubMedGoogle Scholar
  24. 24.
    M.H. Kulke, R.J. Mayer, Carcinoid tumors. N. Engl. J. Med. 340(11), 858–868 (1999)CrossRefPubMedGoogle Scholar
  25. 25.
    F. Assadi, Diagnosis of hypokalemia: a problem-solving approach to clinical cases. Iran. J. Kidney Dis. 2, 115–122 (2008)PubMedGoogle Scholar
  26. 26.
    G.W. Herd, A case of primary hyperparathyroidism, primary hyperaldosteronism and Cushing’s disease. Acta Endocrinol. (Copenh) 107, 371–374 (1984)Google Scholar
  27. 27.
    A. Fertig, M. Webley, J.A. Lynn, Primary hyperparathyroidism in a patient with Conn’s syndrome. Postgrad. Med. J. 56, 45–47 (1980)CrossRefPubMedGoogle Scholar
  28. 28.
    D.E. Hellman, M. Kartchner, N. Komar, D. Mayes, M. Pitt, Hyperaldosteronism, hyperparathyroidism, medullary sponge kidneys, and hypertension. JAMA 244, 1351–1353 (1980)CrossRefPubMedGoogle Scholar
  29. 29.
    R.F. Gagel, S.J. Marx, Multiple endocrine neoplasia, in Williams Textbook of Endocrinology 11th edn, ed. by P.R. Larsen, M. Kroenenberg, S. Helmed, K. Polonsky (WB Saunders & Company, Orlando, 2007) (Section X, Chap 40)Google Scholar
  30. 30.
    A. Falchetti, F. Marini, E. Luzi, F. Tonelli, M.L. Brandi, Multiple endocrine neoplasms. Best Pract. Res. Clin. Rheumatol. 22, 149–163 (2008)CrossRefPubMedGoogle Scholar
  31. 31.
    S.C. Chandrasekharappa, S.C. Guru, P. Manickam, S.E. Olufemi, F.S. Collins, M.R. Emmert-Buck, L.V. Debelenko, Z. Zhuang, I.A. Lubensky, L.A. Liotta, J.S. Crabtree, Y. Wang, B.A. Roe, J. Weisemann, M.S. Boguski, S.K. Agarwal, M.B. Kester, Y.S. Kim, C. Heppner, Q. Dong, A.M. Spiegel, A.L. Burns, S.J. Marx, Positional cloning of the gene for multiple endocrine neoplasia-type 1. Science 276, 404–407 (1997)CrossRefPubMedGoogle Scholar
  32. 32.
    S.S. Guo, M.P. Sawicki, Molecular and genetic mechanisms of tumorigenesis in multiple endocrine neoplasia type-1. Mol. Endocrinol. 15, 1653–1664 (2001)CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • L. Zinnamosca
    • 1
  • L. Petramala
    • 1
  • D. Cotesta
    • 1
  • C. Marinelli
    • 1
  • S. Sciomer
    • 2
  • G. Cavallaro
    • 3
  • A. Ciardi
    • 3
  • R. Massa
    • 4
  • G. De Toma
    • 3
  • S. Filetti
    • 1
  • C. Letizia
    • 1
  1. 1.Department of Clinical SciencesUniversity “Sapienza”RomeItaly
  2. 2.Department of CardiologyUniversity “Sapienza”RomeItaly
  3. 3.Department of Surgery “P. Valdoni”University “Sapienza”RomeItaly
  4. 4.Department of RadiologyUniversity “Sapienza”RomeItaly

Personalised recommendations