PS 17-08 CASES OF ALDOSTERONE-PRODUCING ADENOMAS WHICH WERE CURED BY RADIOFREQUENCY ABLATION: ONGOING CONFIRMATORY CLINICAL STUDY FOR EFFICACY AND SAFETY

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Abstract

Objective:

A clinical study for the efficacy and safety for radiofrequency ablation (RFA) is ongoing in Japan.

Design and method:

Here we report 2 cases of aldosterone-producing adenomas (APA) in which RFA was performed.

Results:

Case 1: A forty-eight-year-old female was pointed out hypokalemia (2.8 mEq/l) by routine medical examination. Her blood pressure was 157/97 and the blood test showed low plasma renin activity (PRA, 0.2 ng/ml/hr) and high plasma aldosterone concentration (PAC, 476 pg/ml). Computed tomography (CT) scan showed 21mm-tumor in the right adrenal gland. Her captopril challenge test, furosemide upright test and oral sodium loading test were all positive and she was diagnosed a right aldosterone-producing adenoma (APA) by adrenal vein sampling (AVS). RFA treatment was performed on June 4th, 2015. She could stop amlodipine on the next day of the intervention and her PAC was normalized (44 pg/ml). Eight month after intervention, her blood pressure remained normal and her active renin concentration (ARC) and PAC also remained normal.

Case 2:

A thirty-five-year-old female visited an orthopedic hospital because of lower-extremity weakness. Her blood test showed hypokalemia (2.2 mEq/l) . She showed prehypertension (136/89) and the blood test showed low PRA (0.4ng/ml/hr) and high PAC (527 pg/ml). CT scan showed 16mm-tumor in the left adrenal gland. By the positivity of 3 loading tests and the result of AVS, she was diagnosed a left APA. RFA treatment was performed on July 2, 2015. Her PAC normalized (78 pg/ml) on the next day and she could stop spironolactone which was given mainly to control her hypokalemia. Two months later, she remained normokalemic and normotensive, and her ARC and PAC also remained normal.

Conclusions:

Both 2 cases were cured by RFA. Long-term follow-up should be needed to define efficacy.

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