SPORADIC UNILATERAL ADRENOMEDULLARY HYPER PLASIA - A RARE CAUSE OF HYPERTENSION

Sporadic adrenomedullary hyperplasia (AMH) is characterized by a clini cal history of hypertension, increased plasma and/or urinary catechola mine levels and histomorphometric evidence of increased adrenal medull ary mass in the absence of MEN 2 syndrome. The case of a 42-year-old f emale patient is reported who presented with typical clinical and labo ratory findings of episodic hypertension and elevated plasma and urina ry catecholamines. Sonography and computed tomography revealed no abno rmality, but I-131-metaiodobenzylguanidine (I-131-MIBG) scintigraphy s howed increased uptake in the right adrenal. Transabdominal unilateral adrenalectomy was performed, The right adrenal gland was macroscopica lly inconspicuous. Upon histomorphometry, however, an increased adrena l medullary cell mass was shown, thus confirming AMH. Two years follow ing surgery the patient is asymptomatic and normotensive.