Geography Student with Hypertension CASE 3 Geography Student with Hypertension

C.P. is a 31-year-old student with a four year history of hypertension. Upon initial evaluation, her K was 2.9 mEq/L, and the possibility of primary aldosteronism was considered. Random serum renin and aldosterone levels were normal, however, and the issue was dropped. Her hypertension was not controlled during treatment with metoprolol, but she did respond favorably to treatment with Aldactazide. She later discontinued medications, her hypertension persisted and K was 3.0 mEq/L.

Physical examination, except for a BP of 185/102, was unremarkable. She did not have a cushingoid habitus.

Laboratory data: Laboratory data: Na 146 (135-145 mEq/L) Cr 0.7 (<1.2 mg/dL) K 3.0 (3.5-5 mEq/L) C1 107 (95-110 mEq/L) CO2 27 (22-29 mEq/L) EKG nonspecific ST changes, strain Your Diagnosis ? Most probably a cortical adenoma Most probably a cortical carcinoma Most probably a pheochromocytoma

Cortical Adenoma CT adrenals -- 2 cm homogeneous mass R adrenal The postoperative course was uncomplicated, and her BP and serum K on follow-up were normal.