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Case Report, Endocrinol Diabetes Res Vol: 2 Issue: 1

Adrenomedullary Hyperplasia in a Patient with Poorly Controlled Hypertension and Neurofibromatosis Type 1: A Case Report

Eleonora Rinaldi1, Valentina Vicennati1*, Elena Casadio1, Cristina Mosconi2, Rita Golfieri2, Renato Pasquali1, Saverio Selva3, Francesco Minni3, Donatella Santini4 and Barbara Corti4
1Endocrinology Unit, Department of Medical and Surgical Sciences, University of Bologna, Italy
2Radiology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy
3General and Emergency Surgery Unit, SOrsola-Malpighi Hospital, University of Bologna, Italy
4Department of Anatomo-Pathology, S. Orsola-Malpighi Hospital, University of Bologna, Italy
Corresponding author : Valentina Vicennati
Division of Endocrinology, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum, Via Massarenti 9, 40138 Bologna, Italy
Tel: 39 051 2144310
Fax: 39 051 6363080
E-mail: [email protected]
Received: November 24, 2015 Accepted: January 20, 2016 Published: January 24, 2016
Citation: Rinaldi E, Vicennati V, Casadio E, Mosconi C (2016) Adrenomedullary Hyperplasia in a Patient with Poorly Controlled Hypertension and Neurofibromatosis Type 1: A Case Report. Endocrinol Diabetes Res 2:1. doi:10.4172/ecdr.1000110

Abstract

A 73-year-old male with a known diagnosis of neurofibromatosis type 1 (or Von Recklinghausen’s disease) was referred to the authors’ unit because of suspected pheochromocytoma. He had poorly controlled hypertension with elevated metanephrine levels and incomplete cortisol suppression at 1 mg overnight dexamethasone test. Adrenal CT showed bilateral adrenal hyperplasia and a nodule suspected of being a pheochromocytoma, while 123I-MIBG SPECTCT showed intense hyperfixation in the left adrenal gland. Left transperitoneal Laparoscopic adrenalectomy was performed and the histologic diagnosis was diffuse and nodular adrenal medullary hyperplasia. We believe that medullary adrenal Hyperplasia is, among the causes of secondary hypertension, a separate entity and should be considered as a possible diagnosis in all patients with poorly controlled hypertension and radiological findings not typical of adenoma.

Keywords: Pheochromocytoma; Adrenal medullary hyperplasia; Adrenal mass; Endocrine hypertension

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