Hypertension for over 10 years, bilateral adrenal nodules found 6 months ago. History: male, 43 years old. The patient developed hypertension without obvious cause over 10 years ago, with the highest reading at 180/115 mmHg. After taking antihypertensive drugs, the blood pressure dropped to 150/90 mmHg, but no further treatment was sought. Six months ago, the patient’s hypertension became poorly controlled. He sought treatment at another hospital, where an abdominal and pelvic CT scan revealed multiple nodules in both adrenal glands, suggesting adenomas. Nodules were visible in the medial limb and junction of the left adrenal gland, measuring approximately 15 mm × 14 mm and 5 mm × 4 mm, with clear boundaries. The plain CT values were about 2 HU and 3 HU, and the enhanced CT values were about 65 HU and 37 HU. A nodule was seen in the lateral limb of the right adrenal gland, measuring approximately 5 mm × 7 mm, with a clear boundary. The plain CT value was about 9 HU, and the enhanced CT value was about 30 HU (Fig. 1). Endocrine examination: aldosterone 485.3 pmol/L, renin activity 0.17 ng/(ml·h), ARR103; captopril test suggested that aldosterone levels could not be suppressed. The patient underwent adrenal venous blood sampling, which showed that the left side was the dominant side for aldosterone secretion. PET/CT suggested nodular thickening of the left adrenal gland with increased radioactive uptake, SUVm4.3; no increased radioactive uptake was seen in the right adrenal gland, suggesting that the left nodule was functional. The patient was then given spironolactone 20 mg bid, olmesartan medoxomil and amlodipine 20 mg qd, and bisoprolol 2.5 mg qd, and his blood pressure is presently under control. During the course of the disease, the patient had no obvious symptoms such as headache, dizziness, limb weakness, numbness in the extremities, or palpitations.