Acute hypokalemic paralysis is a relatively rare cause of acute weakness. It may resolve spontaneously; however, it may be a potential life-threatening condition. Hypertension may be considered the most important finding in combination with hypokalemic paralysis for raising the suspicion of primary hyperaldosteronism (PHA). A 55-year-old hypertensive Mexican woman was admitted to the Emergency Unit with a sudden onset of generalized paralysis. An endocrinological workup and an abdominal magnetic resonance imaging revealed PHA with a 1.5 cm left adrenal tumor. After preoperative medication, left adrenalectomy was performed with single-incision laparoscopic surgery (SILS). The duration of the surgery was 45 min, and no postoperative complication was encountered. The patient was discharged after 24 h. Hypokalemic paralysis may be due to different conditions, but it may raise the suspicion of PHA in combination with a history of generally mild hypertension. Laparoscopic adrenalectomy is the preferred operation for unilateral adrenal adenomas that cause PHA. Single-incision laparoscopic surgery is a step-forward technique that improves the cosmesis, decreases access-related morbidity, and increases the postoperative recovery. We report a case with acute hypokalemic paralysis due to PHA and treated with SILS.
TurKeYepithelium with regular basally located nuclei and without atypia or mitotic activity (Figure C).There were no pancreatic acini or islets.We did not observe Paneth cells or goblet cells.immunohistochemistry was performed using antibodies against CK7 (OV-tL2/30, neomarkers, CA, usA :50), sMA (A4, :300 neomarkers, CA, usA) and CK20 (Ks20.8,:00 neomarkers, CA, usA).immunohistochemistry revealed that sMA was positive in the smooth muscle fibers surrounding the glandular structures (Figure D) while CK7 was diffusely positive in the epithelium lining the glands (Figure E) and CK20 was negative (Figure F). DISCUSSIONAdenomyoma is a lesion that is characterized by a mixture of glandular structures surrounded by smooth muscle fibers.it has several synonyms such as myoepithelial hamartoma (,2,2,3,5), adenomyomatous hamartoma (4,8) and foregut choristoma (6).Adenomyoma of the small intestine distal to duodenum is very rare.to date, only 26 well documented cases of adenomyoma involving small intestine have been reported in the literature (-24).Eighteen male and eight female patients ranging in age from 2 days to 82 years have been reported.The lesion frequently causes intussusception, but some cases were
