Adrenocortical carcinoma with an isolated mineralocorticoid excess and recurrency fourteen years after removal of the tumor.

Abstract

The case of a 31-year-old farmer with primary malignant tumor of the left adrenal cortex, causing pure primary hypermineralocorticism, is reported. The clinical picture consisted of intermittent tetany, periodic muscular weakness, polyuria and polydipsia, hypertension, and edema. This seems to be only the second case of pure hypermineralocorticism caused by adrenocortical carcinoma. Removal of the primary tumor resulted in a complete remission lasting for fourteen years. Thereafter, similar symptoms recurred but disappeared with the removal of the recurrent tumor. The content of aldosterone and cortisol per gram of tissue in the recurrent tumor was very low in comparison with that in the usual adrenocortical adenoma of primary aldosteronism. This case is unique in the following two points; pure mineralocorticoid excess caused by adrenocor-tical carcinoma and the long duration of 14 years for the recurrence after the first surgery.