We describe an unusual 30-year-old female patient with a history of refractory hypertension and hypokalemia. She was diagnosed as primary aldosteronoism with bilateral adrenal hyperplasia 8 years age and blood pressure has been controlled with spironolactone 200mg/day, nifedipine 40mg/day, Cardura 4mg/day and oral potassium supplement till these days.

Recently refractory high blood pressure was developed and about 5×4×4.5cm sized left a-drenal mass was observed by abdominal CT. The hypertension and hypokalemia was controlled by left adrenalectomy.