Ho Chi Minh City Ms. Nguyen, 51 years old, often had numbness, cramps in her limbs, difficulty walking, thought she had a stroke, the doctor examined and discovered a tumor about 2.5 cm in her adrenal gland.
Mrs. Nguyen’s limbs have been numb and cramped since the beginning of the year, and have gotten weaker over the past three months. She was afraid of a stroke, so she went to the doctor and was diagnosed with high blood pressure, hypercalcemia, and hypokalemia. After receiving calcium, her limbs stopped being stiff, but her blood potassium level remained low. She took medication for more than three months but it did not improve.
She went to Tam Anh General Hospital for examination, the test results showed that aldosterone (a hormone secreted by the adrenal gland) increased by more than 100 ng/ml, while the normal index in standing position is 2.21-35.3 ng/dl, lying position is 1.17 - 23.6 ng/dl. Potassium decreased to 1.95 mmol/L, normal for people is 3.5-5.1 mmol/L. Abdominal ultrasound and MRI recorded a spherical tumor in the left adrenal gland, about 2 cm in size, located deep close to the spine, near the aorta, behind the spleen and below the diaphragm.
On September 13, Dr. Nguyen Thi Kim Tuyen, Department of Endocrinology - Diabetes, said that adrenal tumors are the cause of hypokalemia. Low blood potassium often causes patients to have muscle weakness and cramps.
The hormone aldosterone has the effect of increasing sodium reabsorption, increasing potassium excretion through the kidneys to excrete it through the urine, according to the doctor. Too much aldosterone secretion causes the kidneys to excrete too much potassium, leading to hypokalemia. Patients who continuously infuse potassium but do not control the amount of aldosterone hormone will have potassium infused through the kidneys. Potassium is an important electrolyte that helps transport electrical signals to cells in the body. Hypokalemia affects the heart, nerves and muscles, and the patient may have weak limbs. If not controlled early, it increases blood pressure, the risk of heart attack and stroke. Patients are susceptible to arrhythmias leading to cardiac arrest.
Dr. Phan Truong Nam, Department of Urology, Center for Urology - Nephrology - Andrology, indicated retroperitoneal laparoscopic surgery for the patient to access the tumor faster and easier, without affecting other organs in the abdomen. This method also helps the patient to have less pain and recover quickly after surgery.
After one hour of surgery, the team removed a 2 x 2.5 cm tumor, with total blood loss of less than one ml.
Doctor Truong Nam (middle) and his surgical team performed laparoscopic surgery to remove an adrenal tumor from a patient. Photo: Dinh Tien
Three hours after surgery, the patient's health was stable, blood pressure was stable, no need for blood pressure control medication, blood potassium returned to normal levels. Aldosterone hormone levels decreased to a safe level, adrenal hormones were normal.
Patients should avoid heavy work for 4-6 weeks. Regular check-ups and hormone levels should be performed to prevent deficiency.
The adrenal glands are small, triangular endocrine glands located on top of the two kidneys. These glands secrete hormones such as cortisol, aldosterone, androgen, adrenaline, noradrenaline, which help control blood sugar levels, maintain blood pressure, balance sodium and electrolytes...
Aldosterone helps increase sodium reabsorption, increase potassium excretion through the kidneys and out through urine. Excessive secretion of this hormone leads to hyperaldosteronism. Patients with adrenal tumors, adrenal hyperplasia or carcinoma often encounter this condition. Signs of the disease include muscle weakness, transient paralysis, muscle cramps, high blood pressure, hypokalemia...
Annual health check-ups help detect and treat diseases early, preventing complications from the adrenal glands.
Dinh Tien
* Patient name has been changed
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