# Persistent hypokalemia due to Conn’s syndrome resolved by robot-assisted laparoscopic adrenalectomy. A correct diagnostic approach for proper surgical therapy. Case report

**Authors:** Santiago Muñoz-Palomeque, Miguel R Mesías, Diego M Mosquera, Fernando Jiménez Jaramillo

PMC · DOI: 10.1093/jscr/rjaf446 · 2025-06-27

## TL;DR

A woman with long-term low potassium and high blood pressure was cured through robotic surgery after being diagnosed with a rare adrenal tumor.

## Contribution

Highlights the effectiveness of robotic-assisted surgery and structured diagnostics for Conn’s syndrome in resource-limited settings.

## Key findings

- Robot-assisted laparoscopic adrenalectomy resolved hypokalemia and hypertension.
- Histopathology confirmed the presence of an aldosterone-producing adrenal adenoma.
- Robotic surgery provided precision, minimal blood loss, and faster recovery compared to traditional methods.

## Abstract

Primary hyperaldosteronism, or Conn’s syndrome, is a leading cause of secondary hypertension, often presenting with persistent hypokalemia. We report the case of a 44-year-old female with refractory hypokalemia and hypertension, ultimately diagnosed with a unilateral aldosterone-producing adenoma. Diagnostic workup included elevated transtubular potassium gradient and aldosterone-to-renin ratio, confirmed by computed tomography imaging showing a typical left adrenal adenoma. The patient underwent robot-assisted laparoscopic adrenalectomy, resulting in normalized potassium levels and discontinuation of antihypertensive medications. Histopathology confirmed adrenal adenoma. This case underscores the importance of a structured diagnostic algorithm in detecting surgically correctable causes of secondary hypertension. Robotic-assisted surgery offered superior precision, minimal blood loss, and rapid recovery, proving especially advantageous in complex or reoperative cases. In resource-limited settings, where advanced technology is scarce, promoting diagnostic accuracy is vital for effective management. This case advocates for the broader adoption of minimally invasive approaches and encourages investment in surgical innovation in developing countries.

## Linked entities

- **Diseases:** hypokalemia (MONDO:0003019), Conn’s syndrome (MONDO:0001422)

## Full-text entities

- **Genes:** REN (renin) [NCBI Gene 5972] {aka ADTKD4, HNFJ2, RTD}
- **Diseases:** adrenal adenoma (MESH:D018246), hypokalemia (MESH:D007008), hypertension (MESH:D006973), Conn's syndrome (MESH:D006929), blood (MESH:D006402)
- **Chemicals:** aldosterone (MESH:D000450), potassium (MESH:D011188)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12203781/full.md

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Source: https://tomesphere.com/paper/PMC12203781