About 5 months after childbirth, Ms. Hang frequently suffered from headaches, dizziness, and abnormally high blood pressure. An examination at Tam Anh General Hospital Hanoi recorded hypokalemia. Dr. Pham Quang Trung, Deputy Head of the Urology - Andrology Department, suspected an adrenal hormone disorder.

An MRI scan revealed tumors in both adrenal glands: the left measuring approximately 30x26 mm and the right approximately 15x13 mm. Both displayed imaging characteristics consistent with lipid-rich adrenocortical adenomas. Subsequent endocrine evaluation confirmed Ms. Hang had bilateral adrenal adenomas with excessive cortisol secretion.

Ms. Hang's MRI scan revealed tumors in both adrenal glands. Photo: Tam Anh General Hospital

Dr. Trung explained that cortisol, a hormone produced by the adrenal glands, regulates blood pressure, blood sugar, and metabolism. Prolonged excessive levels of this hormone can lead to various disorders, including high blood pressure, hypokalemia, blood sugar and metabolic disorders, and an increased risk of cardiovascular complications.

Given tumors in both adrenal glands, doctors needed to identify which side was primarily secreting cortisol to determine the treatment plan. They also considered preserving the remaining glandular tissue, as removing both glands could lead to adrenal insufficiency, requiring long-term hormone replacement therapy.

Evaluation results indicated the left tumor was secreting significantly more cortisol. The team decided to perform transperitoneal laparoscopic surgery to remove the left adrenal tumor. The smaller right tumor, with lower cortisol secretion, did not require immediate intervention and was preserved.

After surgery, the patient's condition stabilized, blood pressure improved, and blood potassium and metabolic indicators were closely monitored. Adrenal gland function was assessed post-surgery to adjust hormone levels as needed. The patient recovered and was discharged after one week.

Pathology results confirmed the left tumor was a benign adrenocortical adenoma. The right adrenal gland was retained and will undergo regular follow-up to monitor tumor size and hormone secretion, allowing for early detection if the lesion develops or causes more pronounced endocrine disorders.

Dr. Trung noted that adrenal tumors may be asymptomatic and discovered incidentally during ultrasound, CT, or MRI scans. However, patients should not be complacent. They require monitoring, including assessment of tumor size, imaging characteristics, and hormone function, as directed by their doctor.

If experiencing difficult-to-control high blood pressure, hypokalemia, blood sugar disorders, or other unusual metabolic symptoms, patients should promptly consult an endocrinology specialist to identify the cause and receive appropriate treatment.

Thu Giang