Presentation
Hypertensive patient with metabolic alkalosis, hyokalaemia and low renin levels.
Patient Data
Small well-defined ovoid hypodense left adrenal mass of homogeneous density with no calcification. The mean attenuation value on these non-contrast CT was around 2 HU.
Normal appearance of the right adrenal gland.
Annotated image showing the mean attenuation value around 2 HU of the left adrenal mass.
Case Discussion
The clinical presentation and CT features are suggestive of Conn syndrome or primary hyperaldosteronism secondary to adrenal cortical adenoma.
Conn syndrome can be due to adrenal cortical adenoma, bilataeral adrenal hyperplasia, or rarely adrenal carcinoma.
On non-contrast CT scan an attenuation value <10 HU (as in this case) is considered 71% sensitive and 98% specific for a lipid rich adrenal adenoma.