Pure Androgen Secreting Unilateral Adrenal Hyperplasia with Contralateral Adenoma - Case Report and Literature Review

Sofía Saccone, Beatriz Mendoza, Magdalena Otazú, Carla Álvarez and Alvaro Ronco

Department of Endocrinology and Metabolism, School of Medicine, University of the Republic, Uruguay Unit of Oncology and Radiotherapy, Pereira Rossell Women’s Hospital, Uruguay

^*Correspondance to: Sofía Saccone 

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Abstract:

Pure androgen-secreting adrenal tumors are extremely rare. We herewith present the case of a 47-years-old female patient who experienced hirsutism and amenorrhea for five years, intensified in the last year adding clitoromegaly, alopecia, increased muscle mass, and voice deepening. The biochemistry showed elevated serum total testosterone and DHEA-S. The computerized abdominal tomography showed a solid, nodular right adrenal mass deemed uncharacterizable, and an adenoma was reported on the left adrenal gland. A PET study showed low and diffuse metabolism in the right lesion and confirmed the left adenoma. The right-side adrenalectomy was performed by a laparoscopic approach. Signs and symptoms of hyperandrogenism and virilization subsided almost entirely, with decreased total testosterone and DHEA-S levels. The diagnosis is upon clinical suspicion with signs of hyperandrogenism and virilization, elevated serum androgen levels, and imaging evidence of adrenal tissue injury. However, all these are not enough for an accurate diagnosis, being the pathology report of foremost importance for the definitive diagnosis.

Keywords:

Adrenal tumor, Adrenalectomy, Hirsutism, Hyperandrogenism, Virilization

Cite the Article:

Saccone S, Mendoza B, Otazú M, Álvarez C, Ronco A. Pure Androgen Secreting Unilateral Adrenal Hyperplasia with Contralateral Adenoma - Case Report and Literature Review. Clin Case Rep Int. 2020; 4: 1189.