It was speculated that epinephrine released by pheochromocytoma might stimulate adrenocorticotropic hormone release and increase cortical functions. Another possibility was that the adrenocortical adenoma
promoted the release of the cortisol, renin, and angiotensin.
Miyazaki et al., "Combined primary aldosteronism and Gushing's syndrome due to a single adrenocortical adenoma
complicated by Hashimoto's thyroiditis," Internal Medicine, vol.
 looked into the thyroid abnormalities among 40 patients with PA, secondary to both idiopathic bilateral adrenal hyperplasia (IHA) and unilateral adrenocortical adenoma
. It showed that ultrasonographic thyroid abnormalities were present in 60% of the patients with PA compared to 27% in normal controls (p < 0.0001).
Variants of adrenocortical adenoma
include black adenoma, myelolipoma, corticomedullary mixed tumor, oncocytoma, lipoadenoma and myxoid variants.
In the primary or hyporeninemic hyperaldosteronism, autonomous hypersecretion of aldosterone is held by neoplastic tissue, adrenocortical adenomas
or adenocarcinomas, or by nodular hyperplasia of the zona glomerulosa of the adrenal cortex, also known as primary hyperaldosteronism or non neoplastic hyperaldosteronism.
(1-4,14,17,18) Because of the fact that adenomas often have intracytoplasmic fat, resulting in lower attenuation, measurement of the attenuation value in Hounsfield units is helpful in distinguishing adenomas from nonadenomas (14,18); tumors with attenuation values of less than 10 Hounsfield units on an unenhanced CT are often diagnostic of adrenocortical adenomas
(Figure 1, A).
It has also been proposed that adrenal hyperplasia predisposes patients to develop adrenal carcinoma, as a few cases of congenital adrenal hyperplasia are associated with functional adrenocortical adenomas
but not carcinomas (6).
Basal and ACTH-stimulated cortisol and aldosterone release from adrenocortical adenomas
Ozata et al., "MicroRNA expression patterns associated with hyperfunctioning and non-hyperfunctioning phenotypes in adrenocortical adenomas
," European Journal of Endocrinology, vol.