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Unmasking the Silent Culprit: Adrenocortical Carcinoma Revealed through Hypokalemic Periodic Paralysis

Year: 2025
Type: article
Study design: Case Report
Abstract: Primary aldosteronism (PA) is an uncommon condition characterized by hypokalemia, hypertension, with or without the presence of an adrenal mass. Diagnosing and managing PA can be particularly challenging in patients who exhibit atypical symptoms. This case of PA in a 41-year-old man who initially presented with acute flaccid quadriparesis, marked by significant limb weakness and difficulty walking. Further investigations revealed that the patient had hypokalemia which was refractory to potassium supplementation. The patient had experienced a similar episode in the past, which had been overlooked as generalized weakness. Imaging studies, including a computed tomography scan of the abdomen, revealed a left adrenal mass. Surgical adrenalectomy was performed, and the diagnosis of adrenocortical carcinoma was confirmed on histopathology. After surgical excision of the mass, his serum potassium levels normalized, and he became asymptomatic, and antihypertensive medicines were stopped.
Authors: Saurabh Leeladhar Mandaknalli, Nikhil Bhasin, Vikram Londhey, Aditya Patil
Institution: Cooper Hospital
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W7115572015
FWCI:
Cites: 5
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