PRIMARY ALDOSTERONISM WITH BILATERAL MULTIPLE ALDOSTERONE-PRODUCING ADRENAL ADENOMAS

A 41-year-old woman developed primary aldosteronism due to bilateral m ultiple aldosterone-producing adenomas (APA), She was suspected to hav e idiopathic hyperaldosteronism (IHA) 7 years previously, Although pre operative data suggested APA and IHA was suspected in a postoperative microscopic specimen, a definite clinical diagnosis could not be made. Cytochrome P-450 and other enzymes involved in aldosterone synthesis were found in the tumor portions but not in the zona glomerulosa of at tached adrenals, which histopathologically showed ''paradoxical hyperp lasia''. This was a rare case of bilateral multiple APA, which could b e differentiated from IHA by immunohistochemical analysis of adrenal s teroidogenic enzymes.