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Incidental aortic and coronary artery anomalies during investigations for an adrenal tumor

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Patients with high cardio-metabolic risk may associate an adrenal incidentaloma discovered during a routine ultrasound procedure.
Many performing investigations as computed tomography bring more data, for instance anomalies of abdominal vessels as calcification or dilatations.
We introduce such a case. A 72-year old male had arterial hypertension, type 2 diabetes mellitus, dyslipidemia, stable ischemic angina. High blood pressure was partially responsive to medication so an endocrine assessment was done. An abdominal ultrasound discovered a 2.4 centimetre (cm) tumour at the level of right adrenal. The serum potassium was mildly elevated as well as uric acid with normal creatinine.
All the baseline and dynamic adrenal tests pointed a non-secretor profile while the computed tomography showed similar adrenal aspects as did the ultrasound (the tumour was of 2.15 by 2.92 by 1.95 cm). Moreover, the other findings were an aortic aneurysm of 2.96 cm in diameter having a length of 5.05 up to 7.05 cm (and multiple calcifications), a left coronary artery calcification of 2.52 cm. Doppler ultrasound also confirmed a wall thrombus at the level of aortic aneurysm. Because of the vessels anomalies, further investigations were recommended as angio-magnetic resonance imagery and angiography which the patient delayed to perform.
Multidisciplinary approach offers a better perspective of both metabolic and cardiovascular conditions and adrenal masses as well as a potential pathogenic link between these.

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