In severe cases of hyperaldosteronism, profound weakness with bizarre aches and pains may occur acutely. Investigation to rule out biliary tract disease included ultrasonography, which revealed a large left upper abdominal mass. Laboratory investigations demonstrated severe hypokalemia and a high serum aldosterone level with low renin levels. Her recovery was uncomplicated. Management has continued with observation and chemotherapy, although a metastatic pulmonary lesion has developed.
Adrenocortical adenocarcinoma is a lethal disease, requiring aggressive resection if possible.
Chemotherapy and radiotherapy have given disappointing results, so recurrent disease is best managed by repeat resection also, if feasible. Unresectable disease has a uniformly poor outcome.