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Endocrine Abstracts (2015) 37 EP77 | DOI: 10.1530/endoabs.37.EP77

1Department of Internal Medicine I, Endocrinology and Diabetology and Comprehensive Heart Failure Center, Wuerzburg, Germany; 2Centre for Endocrinology, Diabetes and Metabolism, University of Birmingham, Birmingham, UK; 3Clinical Endocrinology, Charité Campus Mitte, Charité University Medicine, Berlin, Germany; 4Medizinische Klinik und Poliklinik IV, University Hospital Munich, Munich, Germany; 5Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; 6Department of Nephrology, Medical Faculty, Heinrich- Heine Universitaet Duesseldorf, Duesseldorf, Germany; 7Division for Specific Endorinology, Medical Faculty, University Duesseldorf, Germany, Duesseldorf, Germany.


Context: Primary aldosteronism (PA) is the most common cause of secondary hypertension. Aldosterone excess can cause oxidative stress and respectively DNA damage in vitro and in vivo and increased levels of oxidative stress have been demonstrated in PA patients. Single case reports describe a coincidence of PA with renal cell carcinoma (RCC) and other tumours. However, so far no data on the prevalence of benign and malignant neoplasms in patients with PA exists.

Patients and methods: In the multicentre MEPHISTO study the prevalence of benign and malignant tumours was investigated in 338 patients with confirmed PA both retro- and prospectively. The SHIP cohort served as a matched control group for subjects with primary hypertension.

Results: Of the 338 patients, 120 (35.5%) had been diagnosed with a tumour at any time, 31 had more than one tumour diagnosis. Malignancy at any life stage was reported in 9.5% of PA patients and in 6.0% of hypertensive controls (P=0.08). Interestingly, PA patients with malignancies in history had significantly higher baseline aldosterone levels at initial diagnosis of PA (P=0.009) and a positive correlation between aldosterone levels and prevalence of malignancies was observed (P=0.02). In total, 159 neoplasms were identified in the PA patients, which were benign in 62% and malignant in 24% of cases. RCC was diagnosed in five patients (13% of all malignancies) and 80% of RCC patients had been diagnosed with renal cysts prior to tumour diagnosis. The relation between tumour formation and aldosterone levels was most abundant in PA patients with RCC.

Conclusion: In this cohort of PA patients a trend towards an increased lifetime prevalence for malignancies was observed which was particularly obvious for RCC and correlated significantly with baseline aldosterone levels.

Disclosure: Else-Kroener-Fresenius

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