ES25P TUMOUR HISTOLOGY DOES NOT PREDICT RESPONSE TO LAPAROSCOPIC ADRENALECTOMY IN CONN'S SYNDROME

Abstract

Introduction: Primary aldosteronism (Conn's syndrome) due to an aldosterone producing adenoma is a frequent cause of surgically correctable hypertension. It is unknown exactly which patients will have improved blood pressure (BP) control following resection. This study was undertaken to determine if histology correlated to post operative BP control in Conn's adenoma patients. We hypothesized that degree of zona glomerulosa hyperplasia would predict response to surgery.Methods: The University of Sydney Endocrine Surgery Database was queried for 20 consecutive patients who did and 20 consecutive patients who did not have improved BP control following surgery for Conn's Syndrome. Histology was reviewed to identify presence and degree of zona glomerulosa hyperplasia as well as dominate adenoma cell type: glomerulosa (G), reticularis (R) or fasciculata (F). Responders were defined as taking no BP medication or reduction of more than 2 medications 3 months after surgery. Student's t and Fischer's Exact tests were used to determine significance (p < 0.05 significant).Results: 20 responders and 13 non‐responders had histology available for review. Age and sex between groups were not significantly different. Glomerulosa hyperplasia was present in 65% and 77% of responders and non‐responders respectively (p = 0.7). Percentage cell type in responder tumours: 0% G, 35% F, 0% R, 65% mixed. Percentage cell type of non‐responders, 0%G, 38% F, 0% R, 62% mixed with no significant difference in cell type between groups.Conclusion: Tumour histology does not influence clinical outcome following resection of Conn's adenomas. Improvement in BP following resection is unlikely related to local tumour characteristics.