Diagnosis and Localization of Aldosterone-Producing Adenomas by Adrenal-Vein Catheterization

EVEN when the diagnosis of primary aldosteronism is obvious before operation, there is no way to localize the adenoma. Preoperative demonstration of the tumor radiographically, as by retroperitoneal pneumography and aortography, is rarely successful because of its relative avascularity and its small size (from a few millimeters to several centimeters in dimension), which may also cause it to escape notice during transabdominal exploration. A bilateral adrenalectomy may thus be necessary.A method is needed to improve preoperative diagnostic certainty in many ambiguous cases and to localize the tumor in one or, rarely, both adrenal glands. A comparison of aldosterone concentrations . . .