Endocrine Abstracts

Introduction: We present a case of primary aldosteronism (PA) with adrenal mass, where lateralization of aldosterone production by adrenal-vein sampling (AVS) was discordant with cross-sectional imaging. We highlight an approach to investigation of PA using functional nuclear imaging, and show that subclinical cortisol excess may impact the reliability of AVS.Case: 70 year old female with 2.6 cm left-sided adrenal mass, ...

Introduction: Adrenal vein sampling (AVS) is considered gold-standard for diagnosis of unilateral primary aldosteronism (PA), and necessary pre-surgery. Imaging-AVS discordance may occur in up to 30-40% of PA-AVS series, and presents a diagnostic dilemma which may preclude surgery. Lateralization by AVS is defined as the ratio of aldosterone concentrations normalized by cortisol from each adrenal vein, and is thus sensitive to any pathologic asymmetry in corti...