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The diagnosis and management of multiple unilateral adrenal adenomas in PHA represent a unique challenge. Adrenal venous sampling (AVS) has become a pivotal diagnostic tool in these cases, providing critical information for accurate localization of aldosterone production. Here, we describe a rare case of a 52-year-old female with a history of resistant essential hypertension who presented with multiple unilateral adrenal adenomas concomitant with adrenal hyperplasia in a case of primary hyperaldosteronism. The use of AVS in localization of aldosterone production was the determining factor in deciding the ultimate management of the patient, leading to successful follow-up on medical therapy with spironolactone.<\/jats:p>","DOI":"10.1177\/2050313x261487243","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:28:05Z","timestamp":1788308885000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The value of adrenal venous sampling in unveiling the conundrum of double unilateral adrenal adenomas in a case of primary hyperaldosteronism"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9929-7064","authenticated-orcid":false,"given":"Maab F.","family":"Elhaj","sequence":"first","affiliation":[{"name":"Hamad Medical Corporation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9330-5740","authenticated-orcid":false,"given":"Elabbass A.","family":"Abdelmahmuod","sequence":"additional","affiliation":[{"name":"Hamad Medical Corporation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen F.","family":"Beer","sequence":"additional","affiliation":[{"name":"Hamad Medical Corporation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarik","family":"Elhadd","sequence":"additional","affiliation":[{"name":"Hamad Medical Corporation"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_3_6_2_2","first-page":"215","article-title":"Primary aldosteronism: a new clinical entity","volume":"68","author":"Conn JW","year":"1955","unstructured":"Conn JW, Louis LH. 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