Adrenal Cortical Adenoma Initially Presenting with Acute Aortic Dissection, Hypokalemic Paralysis, and Marked Hypertension

Abstract

Adrenal cortical adenoma is a rare cause of secondary hypertension and may present with elevated blood pressure and hypokalemia. We reported a 38-year-old female with adrenal adenoma presenting with a rare initial manifestation of severe back pain. Acute aortic dissection, marked hypertension and lower leg paralysis were noted simultaneously. Stanford type B aortic dissection and left adrenal tumor were noted by computed tomography angiography. Hypokalemia, high serum aldosterone and low renin level make the clinical suspicion of adrenal adenoma. Blood pressure was under optimal treatment after intensive medical treatment and lower leg paralysis was resolved after correction of hypokalemia. The patient underwent laparoscopic adrenectomy later and the pathology report proved to be adrenal adenoma. Blood pressure and serum potassium level returned to normal after adrenectomy and the patient was uneventful in the following days without any medication.