Primary Aldosteronism

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Abstract
An intravenously administered tracer dose of 19-iodocholesterol labeled with radioactive iodine (131) was given to four patients whose aldosterone-producing tumors had been visualized by adrenal venography. Scintillation scanning by means of a computer-assisted Anger camera gave clear visual evidence of concentration of radioactivity at the site of the tumor. The position of the tumors was confirmed surgically. A fifth case exhibited diffuse adrenal uptake of radioactivity without an area of concentration, and at surgery disclosed bilateral adrenal hyperplasia ("idiopathic" aldosteronism). Tests repeated after unilateral adrenalectomy for tumor demonstrate dramatic disappearance of uptake of radioactivity on the side from which the tumor was removed. Special preoperative studies disclosed that dexamethasone suppression, followed by a second dose of radioactive cholesterol, inhibited completely the uptake of radioactivity by both adrenals in the hyperplasia case. In primary aldosteronism, however, uptake of radioactivity was brightly visible on the tumor side, while uptake by the contralateral gland was inhibited.

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