両側多発性副腎腺腫による原発性アルドステロン症

PRIMARY ALDOSTERONISM WITH BILATERAL MULTIPLE ADRENAL ADENOMAS

　両側副腎腺腫による原発性アルドステロン症に対し，右副腎全摘除術および左副腎亜全摘を施行し，その臨床経過について検討した。右副腎には25×25×10mmおよび3×3×2mm，左副腎には8×7×4mmおよび7×6×3mmの表面平滑淡黄色の腫瘤を認めた。組織学的には明澄細胞を主たる構成成分とする腺腫で，一部充実細胞も認められた。術後補充療法中止後，副腎機能は正常に保たれ，血漿アルドステロン値，コルチゾールおよび血漿レニン活性は正常化した。

An unusual case of primary aldosteronism with bilateral multiple adrenal adenomas in 31-year-old male is reported. The three tumors were revealed by adrenal selective venography and adrenal venous aldosterone levels. However computerized axial tomography and adrenal scintigraphy could only demo-nstrate the right biggest tumor. Laboratory data suggested the presence of bilateral adrenal adenoma which was confirmed by subtotal adrenalectomy. On the right side, two tumors were seen, 25 × 25 ×10 mm and 3 × 3 × 2mm in size and on the left side, two tumors were 8 × 7 × 4mm and 7 × 6 × 3mm in size. Postoperative course was uneventful.