{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T20:03:54Z","timestamp":1771531434798,"version":"3.50.1"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Aldosterone-producing adenoma (APA) is one of the main types of primary aldosteronism (PA). APAs are predominantly unilateral, whereas bilateral APAs are rare. Currently, clinical experience in the diagnosis and treatment of bilateral APAs is limited, posing significant challenges. This article reports the case of a PA patient with bilateral adrenal nodules. Adrenal venous sampling (AVS) revealed no dominant lateral secretion, but <jats:sup>68<\/jats:sup>Ga-Pentixafor PET\/MR imaging, which targets CXCR4, revealed bilateral positive lesions. The patient achieved biochemical and clinical remission after undergoing bilateral partial adrenalectomy, and CYP11B2 immunohistochemical staining confirmed that both nodules were APAs. This case report suggests that <jats:sup>68<\/jats:sup>Ga-Pentixafor nuclear imaging, which targets CXCR4, is a noninvasive and reliable method for PA subtyping and may be the optimal method for the definitive diagnosis of bilateral APA. Bilateral partial adrenalectomy may be an effective and safe surgical procedure for the treatment of bilateral APAs. This study provides new insights and considerations for clinicians in the diagnosis and treatment of bilateral APAs.<\/jats:p>","DOI":"10.3389\/fendo.2025.1558841","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T04:10:22Z","timestamp":1746763822000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical diagnosis and treatment of a patient with hypertension, hypokalemia, and bilateral adrenal adenomas"],"prefix":"10.3389","volume":"16","author":[{"given":"Tingting","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuchun","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-022-00730-2","article-title":"Primary aldosteronism \u2014 a multidimensional syndrome","volume":"18","author":"Turcu","year":"2022","journal-title":"Nat Rev Endocrinol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnad026","article-title":"Treating primary aldosteronism-induced hypertension: novel approaches and future outlooks","volume":"45","author":"Mullen","year":"2024","journal-title":"Endocr Rev"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00210-2","article-title":"Diagnosis and treatment of primary aldosteronism","volume":"9","author":"Reincke","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.09975","article-title":"Targeting CXCR4 (CXC chemokine receptor type 4) for molecular imaging of aldosterone-producing adenoma","volume":"71","author":"Heinze","year":"2018","journal-title":"Hypertension"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.121.261964","article-title":"Functional characterization of adrenocortical masses in nononcologic patients using 68 Ga-pentixafor","volume":"63","author":"Ding","year":"2022","journal-title":"J Nucl Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad421","article-title":"The value of targeting CXCR4 with 68Ga-pentixafor PET\/CT for subtyping primary aldosteronism","volume":"109","author":"Zheng","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.55609","article-title":"Accuracy of gallium-68 pentixafor positron emission tomography\u2013computed tomography for subtyping diagnosis of primary aldosteronism","volume":"6","author":"Hu","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30135-3","article-title":"Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort","volume":"5","author":"Williams","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1093\/qjmed\/hcm101","article-title":"APA Bilateral aldosterone-producing adenomas: differentiation from bilateral adrenal hyperplasia","volume":"101","author":"Wu","year":"2007","journal-title":"QJM"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061","article-title":"The\u00a0management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002520","article-title":"Subtype diagnosis, treatment, complications and outcomes of primary aldosteronism and future direction of research: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension","volume":"38","author":"Mulatero","year":"2020","journal-title":"J Hypertens"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-21-0338","article-title":"Somatic mutations in adrenals from patients with primary aldosteronism not cured after adrenalectomy suggest common pathogenic mechanisms between unilateral and bilateral disease","volume":"185","author":"Hacini","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2015.100","article-title":"A case of bilateral aldosterone-producing adenomas differentiated by segmental adrenal venous sampling for bilateral adrenal sparing surgery","volume":"30","author":"Morimoto","year":"2016","journal-title":"J Hum Hypertens"},{"key":"B14","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1007\/s00330-022-09058-x","article-title":"Functional nodules in primary aldosteronism: identification of CXCR4 expression with 68Ga-pentixafor PET\/CT","volume":"33","author":"Gao","year":"2023","journal-title":"Eur\u00a0Radiol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2025.109156","article-title":"Evaluating the value of chemokine receptor type 4-targeted PET imaging in diagnosing primary aldosteronism lateralization: A comparison with adrenal venous sampling","volume":"181","author":"Lu","year":"2025","journal-title":"Surgery"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1291775","article-title":"A comparison of the performance of (68) Ga-Pentixafor PET\/CT versus adrenal vein sampling for subtype diagnosis in primary aldosteronism","volume":"15","author":"Yin","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015142159","article-title":"Intra-adrenal aldosterone secretion: segmental adrenal venous sampling for localization","volume":"278","author":"Satani","year":"2016","journal-title":"Radiology"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-1161","article-title":"Is there a role for segmental adrenal venous sampling and adrenal sparing surgery in patients with primary aldosteronism","volume":"173","author":"Satoh","year":"2015","journal-title":"Eur J Endocrinol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00253-4","article-title":"Adrenal surgery for bilateral primary aldosteronism: an international retrospective cohort study","volume":"10","author":"Williams","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1210\/jcemcr\/luad144","article-title":"Bilateral cortical-sparing adrenalectomy for the treatment of bilateral aldosterone-producing adenomas","volume":"1","author":"Nanba","year":"2023","journal-title":"JCEM Case Rep"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1558841\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T04:10:22Z","timestamp":1746763822000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1558841\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,9]]},"references-count":20,"alternative-id":["10.3389\/fendo.2025.1558841"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1558841","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,9]]},"article-number":"1558841"}}