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This case scenario presents the dilemma in the diagnosis of severe, resistant HTN in a 51-year-old schoolteacher. He had several episodes of hypertensive emergencies presenting with hypokalemia on one hand and one episode of hyperkalemia following the initiation of ARB on the other hand. His radiologic imaging studies including adrenal CT scan and DTPA renogram revealed renal artery stenosis and an adrenal incidentaloma. After a thorough clinical and biochemical evaluation coupled with imaging analysis, he was diagnosed of having ectopic pheochromocytoma with renal artery stenosis, a rare combination leading to severe and resistant HTN.

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A 51-Year-Old Male with Severe Uncontrolled HTN and Unilateral Adrenal Mass

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  • 发表日期：

    2025年

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  • Sharmin Jahan

摘要

This case scenario presents the dilemma in the diagnosis of severe, resistant HTN in a 51-year-old schoolteacher. He had several episodes of hypertensive emergencies presenting with hypokalemia on one hand and one episode of hyperkalemia following the initiation of ARB on the other hand. His radiologic imaging studies including adrenal CT scan and DTPA renogram revealed renal artery stenosis and an adrenal incidentaloma. After a thorough clinical and biochemical evaluation coupled with imaging analysis, he was diagnosed of having ectopic pheochromocytoma with renal artery stenosis, a rare combination leading to severe and resistant HTN.