Interesting case of the week 9/3/2021: When radiologists miss adrenal tumors
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- เผยแพร่เมื่อ 6 มี.ค. 2022
- I love radiologists.
In fact, my younger brother and my best friend from medical school are both radiologists. But radiologists sometimes miss things, and this is especially true when it comes to #adrenaltumors. In particular, small aldosterone producing #adrenaladenomas can easily be missed.
These small adrenal adenomas that overproduce aldosterone cause primary #hyperaldosteronism or #ConnsSyndrome.
Often these aldosterone-producing adrenal tumors are quite small, less than half an inch or about one centimeter. The is the size of a pea or a small grape.
Why do radiologists miss small adrenal tumors on CT scans?
Radiologists look at hundreds of CT scans in a single day. They look at dozens and dozens of different organs in your body. When a radiologist looks at the CT scan of the chest and abdomen, they review the lungs, heart, liver, kidneys, spleen, pancreas, bowels, and all sorts of different organs. A small adrenal tumor can easily be missed.
The patient in her mid-fifties from the Mountain West had high blood pressure for decades. She was not overweight, diabetic or had any real reasons for having high blood pressure. Despite this, she required 4 blood pressure medications including Spironolactone.
Her aldosterone level was very high and her renin level very low (suppressed). She also had problems with too low potassium. She had a potassium as low as 2.4 once. This is dangerously low. She was a “slam-dunk Aldo”. This means it is so obvious that a 3rd year medical student should be able to diagnose it.
However, on the scan of her adrenals, the report stated that the adrenal glands were normal.
When I reviewed her CT scan, she had on obvious left adrenal tumor, measuring 13 mm.
Figure 1 and 2 shows the aldosterone-producing adrenal adenoma on the CT scan and after it was removed by a 19-minute Mini Back Scope Adrenalectomy (MBSA).
Now the patient is cured of her primary hyperaldosteronism and Conn’s syndrome and is doing fantastically.
So, remember, it is very important that the radiologist knows that you have an adrenal problem, and that they scrutinize the adrenal gland on the scan very carefully.
To become my patient, fill out the form at this link: www.adrenal.com/adrenal-surgeon
My story is I had a 14 centimeter tumor on my left adrenal caused me all kind of pain and extremely high BP, so I found out later. Do you know the darn doctors jerked me around for 8 months saying it was benign and doing all kinds of blood and urine tests which were pretty much normal. (So don't put your stock into these tests.) 8 months later another scan revealed it was now 21 centimeters. Yes enormous and I could feel it. They still didn't believe it was cancer. I lost it when the doctor said this. I told him he was going to remove the damn thing immediately. They did, it was cancer and everyone, but me, was shocked. I had told these doctors from day 1 it was cancer. Well, I ended up losing my adrenal gland, left kidney, spleen and 20% of my pancreas. I did no Chemo or radiation as it was a cancer for which there were only 8 documented cases in medical literature and all other patients had passed away. I did alot or natural things and Thank God, I am here 13 years later to talk about it.
So when I see a doctor say well it doesn't appear to be cancer or it is just an incidentaloma, I cringe. If they are wrong, they don't have to do the dying.
Wow! I am so glad you survived that surgery. Did you do anything natural to try and slow the growth of the tumor while waiting for actual answers? It is so frustrating and I am in a similar boat.
Are MRI's better then CTs?
How do you get to tell the Radiologist what to look for? Especially when you have had previous scans that they would want to compare.
So, when it is a tumor, do you remove just the tumor from the adrenal gland or you remove the whole adrenal gland with the tumor?
Yep. I have an enlarged adrenal but they said no tumor. 🤷
I have this disease. What causes the adrenal gland to overproduce the Aldosterone in the first instance?
I've now had 3 ct scans all negative but a very positive ARR blood test!