Bilateral adrenal tumours in primary aldosteronism: localization of a unilateral aldosteronoma by dexamethasone suppression scan

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Abstract
In a patient with primary aldosteronism, in which the postural endocrine tests suggested the presence of an aldosteronoma rather than hyperplasia, bilateral adrenal tumours were found by computer tomography. Adrenal scintigraphy using 6–131I‐iodomethyl‐19‐norcholesterol (NP59) during dexamethasone suppression showed early unilateral adrenal visualization on the left side. After removal of the left adrenal gland, which contained a 2 × 2 × 2 cm adenoma, the blood pressure and aldosterone levels returned to normal. A CT‐scan, performed 1 year after the pre‐operative CT‐scan, showed no change in size of the right adrenal tumour, consistent with a non‐functioning adenoma. In this patient, the NP59 scan adequately distinguished a non‐functioning from an aldosterone‐producing adrenal tumour.