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Lang K, Weber K, Quinkler M, Dietz AS, Wallaschofski H, Hannemann A, Friedrichs N, Rump LC, Heinze B, Fuss CT, Quack I, Willenberg HS, Reincke M, Allolio B, Hahner S. Prevalence of Malignancies in Patients With Primary Aldosteronism. J Clin Endocrinol Metab 2016; 101:1656-63. [PMID: 26844843 DOI: 10.1210/jc.2015-3405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CONTEXT Primary aldosteronism (PA) is the most common cause of secondary hypertension. Aldosterone excess can cause DNA damage in vitro and in vivo. Single case reports have indicated a coincidence of PA with renal cell carcinoma and other tumors. However, the prevalence of benign and malignant neoplasms in patients with PA has not yet been studied. PATIENTS AND DESIGN In the multicenter MEPHISTO study, the prevalence of benign and malignant tumors was investigated in 335 patients with confirmed PA. Matched hypertensive subjects from the population-based Study of Health in Pomerania cohort served as controls. RESULTS Of the 335 PA patients, 119 (35.5%) had been diagnosed with a tumor at any time, and 30 had two or more neoplasms. Lifetime malignancy occurrence was reported in 9.6% of PA patients compared to 6.0% of hypertensive controls (P = .08). PA patients with a history of malignancy had higher baseline aldosterone levels at diagnosis of PA (P = .009), and a strong association between aldosterone levels and the prevalence of malignancies was observed (P = .03). In total, 157 neoplasms were identified in the PA patients; they were benign in 61% and malignant in 25% of the cases (14% of unknown dignity). Renal cell carcinoma was diagnosed in five patients (13% of all malignancies) and was not reported in controls CONCLUSION Compared to hypertensive controls, the prevalence of malignancies was positively correlated with aldosterone levels, tended to be higher in PA patients, but did not differ significantly.
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Affiliation(s)
- K Lang
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - K Weber
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - M Quinkler
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - A S Dietz
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - H Wallaschofski
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - A Hannemann
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - N Friedrichs
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - L C Rump
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - B Heinze
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - C T Fuss
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - I Quack
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - H S Willenberg
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - M Reincke
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - B Allolio
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
| | - S Hahner
- Department of Internal Medicine I (K.L., K.W., B.H., B.A., S.H.), University Hospital Würzburg, 97080 Würzburg, Germany; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, 10117 Berlin, Germany; Medizinische Klinik und Poliklinik IV (A.S.D., M.R.), University Hospital Munich, 80336 Munich, Germany; Institute of Clinical Chemistry and Laboratory Medicine (H.W., A.H., N.F.), University Medicine Greifswald, 17489 Greifswald, Germany; Private Practice Endocrinology (H.W.), 99084 Erfurt, Germany; Department of Nephrology, Medical Faculty (L.C.R., I.Q.), Heinrich-Heine University Düesseldorf, 40225 Düsseldorf, Germany; and Department of Endocrinology and Metabolism (H.S.W.), Rostock University Medical Center, 18147 Rostock, Germany; Comprehensive Cancer Center Mainfranken & Department of Medicine I (C.T.F.), University of Wuerzburg, 97080 Wuerzburg, Germany
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