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Case report
Potassium losing, aldosterone producing adrenocortical carcinoma: a rare presentation
  1. Zahir S Hussain,
  2. Smitha S Rao,
  3. Wajith Z Hussain and
  4. Shikhil Puzhakkal
  1. Department of Endocrine and Breast Surgery, Madras Medical College and Research Institute, Chennai, Tamil Nadu, India
  1. Correspondence to Professor Zahir S Hussain; zahirdr{at}


Adrenocortical carcinomas (ACCs) are rare malignancies with an incidence of one to two per million per year. Aldosterone-producing ACCs (APACs) are extremely rare with an incidence less than 1%. We describe a rare case of APAC, presenting with episodic lower-limb weakness and hypertension. Our patient was found to have serum aldosterone levels of 20.8 ng/dL (2.5–15.2) with persistent hypokalaemia and a 9.7×8.3×7.7 cm right adrenal mass, which was suspicious of malignancy on evaluation. He underwent a complete surgical resection which confirmed the diagnosis of ACC and normalised his aldosterone and potassium levels. He was then subjected to postoperative chemotherapy. Postoperative adjuvant chemotherapy with mitotane has a role in preventing recurrence.

  • hypertension
  • adrenal disorders
  • endocrine cancer
  • surgical oncology
  • urological surgery

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  • Contributors All authors were responsible for patient diagnosis and management. ZSH and SSR were responsible for the data collection, preparation of manuscript and literature review. WZH and SP took part in the review and revision of the article before submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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