Incidentally Discovered Aldosterone and Cortisol Cosecreting Adrenal Cortical Adenoma

As the frequency of performing abdominal computed tomography (CT) scanning is increasing, owing to the increased quality of medical services, the prevalence of adrenal incidentalomas is also rising. Although most adrenal incidentalomas are benign and nonfunctioning, a substantial proportion demonstrates subtle hormonal hypersecretion. Adrenal adenomas mainly manifest as autonomous cortisol secretion, with a reported prevalence ranging from 1% to 47%, depending on the applied diagnostic criteria [1]. However, adrenal tumors secreting aldosterone and cortisol simultaneously are rare, especially among incidentalomas [2,3]. The recognition of cortisol and aldosterone cosecreting adrenal adenomas will have implications for the perioperative management, and is necessary for administering glucocorticoid treatment to avert the possibility of adrenal crisis [4]. Herein, we present a case of an incidentally detected adrenal adenoma secreting excess cortisol and aldosterone and discuss how this case was managed.