ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Adrenal Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1558841
This article is part of the Research TopicComorbidities of adrenal-related endocrine disordersView all 6 articles
Clinical diagnosis and treatment of a patient with hypertension, hypokalemia, and bilateral adrenal adenomas
Provisionally accepted
- 1West China Hospital, Sichuan University, Chengdu, China
- 2Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Aldosterone-producing adenoma (APA) is one of the main types of primary aldosteronism (PA). APAs are predominantly unilateral, whereas bilateral APAs are rare. Currently, clinical experience in the diagnosis and treatment of bilateral APAs is limited, posing significant challenges. This article reports the case of a PA patient with bilateral adrenal nodules. Adrenal venous sampling (AVS) revealed no dominant lateral secretion, but 68 Ga-Pentixafor PET/MR imaging, which targets CXCR4, revealed bilateral positive lesions. The patient achieved biochemical and clinical remission after undergoing bilateral partial adrenalectomy, and CYP11B2 immunohistochemical staining confirmed that both nodules were APAs. This case report suggests that 68 Ga-Pentixafor nuclear imaging, which targets CXCR4, is a noninvasive and reliable method for PA subtyping and may be the optimal method for the definitive diagnosis of bilateral APA. Bilateral partial adrenalectomy may be an effective and safe surgical procedure for the treatment of bilateral APAs. This study provides new insights and considerations for clinicians in the diagnosis and treatment of bilateral APAs.
Keywords: bilateral aldosterone-producing adenomas, subtyping diagnosis, 68 Ga-Pentixafor PET/MR, CYP11B2, bilateral partial adrenalectomy
Received: 11 Jan 2025; Accepted: 21 Apr 2025.
Copyright: © 2025 Zhang, Chen, Zhang, Tan, Li, Zhu and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yan Ren, West China Hospital, Sichuan University, Chengdu, China
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