William F. Young, MD; Anna M. Sawka, MD; Jon A. van Heerden, MD
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Young W., Sawka A., van Heerden J.; Adrenalectomy for Primary Aldosteronism. Ann Intern Med. 2003;138:158-159. doi: 10.7326/0003-4819-138-2-200301210-00024
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Published: Ann Intern Med. 2003;138(2):158-159.
Dr. Martinez makes an important point regarding the key role of adrenal venous sampling in the subtype evaluation of primary aldosteronism. In many patients with primary aldosteronism, CT imaging may reveal normal-appearing adrenals, minimal unilateral adrenal limb thickening, a unilateral microadenoma (≤ 1 cm), or bilateral macroadenomas. A small aldosterone-producing adenoma may be labeled incorrectly as bilateral idiopathic hyperplasia on the basis of CT findings of bilateral nodularity or normal-appearing adrenals (1). Also, apparent adrenal microadenomas and macroadenomas may represent areas of hyperplasia or nonfunctioning cortical adenomas, and unilateral adrenalectomy would be inappropriate.
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