A case of adrenal aldosteronoma with horseshoe kidney and duplicated inferior vena cava.

A 43-year-old man, with known hypertension, was brought to A&E with acute weakness of legs. His blood pressure was 150/95mm Hg and he had decreased muscle power of both legs. Investigations: severe hypokalaemia (Kþ 1.9mmol/l), metabolic alkalosis, despite normal renal and liver functions. He had an elevated serum aldosterone (364 pg/ml, normal range: 69–109 pg/ml) with normal thyroid and adrenal function. Magnetic resonance imaging and angiography (MRI and MRA) revealed a right adrenal adenoma of 2 cm in diameter (Figure 1A), horseshoe kidney of fused lower poles (Figure 1B) and duplicated inferior vena cava (IVC) (Figure 1C). The I adrenal scintigraphy following dexamathasone suppression, revealed a focal area of increased uptake of radioactivity in the right adrenal area up to 3 days after injection.