Marques and colleagues report an unusual cause of hypertension detected in pregnancy. An incidental adrenal mass was detected during obstetric ultrasound in a woman with a history of pre-eclampsia, hypertension requiring three agents, and also hypokalaemia. She did not have features of Cushing’s syndrome and had aldosterone and renin levels that were low rather than high.

The patient was found to have grossly elevated levels of 11-deoxycorticosterone (DOC), a mineralocorticoid precursor. Magnetic resonance imaging demonstrated a 12-cm complex cystic adrenal mass. Treatment with antihypertensives (labetalol, doxazosin, diltiazem) continued until the postpartum period, at which point the woman underwent surgical resection of what was found to be an adrenocortical neoplasm. Her hypertension and hypokalaemia resolved post-operatively.

The authors discuss the differential diagnosis of a picture of mineralocorticoid excess, as well as what is currently known about DOC-producing adrenal tumours.

Read the full article in Endocrinology, Diabetes & Metabolism Case Reports doi: 10.1530/EDM-18-0164