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Endocrine Surgery

Adrenal Tumors

Aldosterone producing tumors or Conn’s syndrome

  • What is an aldosteronoma?
    • Most commonly a benign, small tumor of the adrenal gland that produces excessive amounts of the hormone aldosterone.
    • You can have a single tumor (2/3 of patients) or bilateral hyperplasia (1/3 of patients) where both entire adrenal glands are involved.
    • Aldosterone works by retaining sodium and water in the body and getting rid of potassium.

  • What are the symptoms?
    • Hypertension that can be difficult to control and requires multiple medications.
    • Low potassium. This can lead to muscle weakness or cramps, fatigue, and numbness.

  • How is it diagnosed?
    • The first parts of diagnosis are a series of blood tests and imaging. There is no role for needle biopsy and is contraindicated.
    • Some patients may require more extensive blood tests or an interventional radiology procedure called adrenal vein sampling to complete the work-up.

  • What is adrenal vein sampling? Will I need this procedure?
    • Adrenal vein sampling is performed by interventional radiologists usually as an outpatient procedure. It involves sampling the blood in both of your adrenal veins via a large guidewire directed catheter and comparing the level of aldosterone on the right and lefts sides.
    • Patients that are over 40 and those without definitive evidence of a solitary tumor on imaging are referred for this procedure.

  • What is the treatment?
    • All patients need to be treated to help prevent and/or diminish potential cardiovascular complications of untreated high blood pressure.
    • Unilateral (one side) adrenal tumor: laparoscopic surgical removal is the treatment of choice.
    • Bilateral disease: medical treatment with aldosterone-antagonist drugs and a low salt diet.

  • Will I be off all my high blood pressure medication after the surgery?
    • The rule of thumb is 1/3 of patients are able to stop all their blood pressure medications, 1/3 are able to decrease the number of medications, and 1/3 show improvement in symptoms and ability to control the blood pressure but need to stay on their medications. However, your body generally needs time to reregulate itself so your medication may be weaned off slowly.

  • Do I need regular follow-up visits?
    • Yes. After your post-op visit, your follow-up will continue with your endocrinologist and primary physician.


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University of Southern California
Upper G.I. and General Surgery

1450 San Pablo Street
Healthcare Consultation Center 4
Suite 6200
Los Angeles, CA 90033

Phone: (323) 865-3918
Fax: (323) 865-3539

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