Recurrence of left adrenal tumor 11 years after removal, discovered 5 years ago: female, 54 years old. The patient developed hypertension 13 years ago without any obvious cause, with a maximum of 160/90 mmHg, treated with nifedipine controlled-release tablets 30 mg qd; blood pressure was controlled at around 150/80 mmHg. Eleven years ago, a nodular lesion was found in the lateral limb of the left adrenal gland in our hospital, with a diameter of about 1.7 cm. Blood potassium 3.0 mmol/L. Endocrine-related tests: renin 0.1 ng/(ml·h) and aldosterone 363.42 pmol/L. The diagnosis was considered primary hyperaldosteronism, and laparoscopic left adrenal tumor removal was performed. Postoperative pathology report: consistent with adrenal cortical nodular hyperplasia. After surgery, blood pressure was partially relieved, regular oral nifedipine controlled-release tablets were continued, blood pressure was controlled at around 130/80 mmHg, and blood potassium returned to normal. Five years ago, blood pressure rose again, with a maximum of 160–170/100–110 mmHg. She visited our outpatient clinic; rechecked blood potassium 3.1 mmol/L. Renin 0.17 ng/(ml·h) and aldosterone 358.44 pmol/L. Captopril test: aldosterone 274.23 pmol/L before medication and aldosterone 254.01 pmol/L after medication. Abdominal enhanced CT showed: left adrenal occupation, diameter about 1.6 cm, considering adenoma possibility (Figs. 1 and 2). Treated with spironolactone 20 mg tid, blood pressure control was not good, and the patient stopped medication on her own. Two months ago, the patient had hand numbness and weakness; outpatient rechecked blood potassium 2.9 mmol/L. After oral potassium supplementation and spironolactone treatment, rechecked blood potassium 3.7 mmol/L. Now admitted for surgery.