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I was looking for a case report or example to match something I've come across that I thought highly unlikely to the point of being untrue. That is a adrenocortical adenoma (AA) was functional but solely producing testosterone in a male. The patient (pt) reports no steroid or recreational drugs (tox comes up clean). Endocrine panel only shows highly elevated testosterone. AA was detected in imaging.

I'm less specifically interested in the individual case, but can provide more details if needed (I was only an ID consult ).

My understanding is that functional AA are already rare, and that when they do produce hormones, it tends to be several (a broad array of over production). Has anyone heard of or can find a case report of a functional AA producing a narrow spectrum or single hormone? I understand that pure androgen-secreting tumors are rare to begin with, but even then multiple androgens are often produced.

I found this case but I'm trying to track down more details on it before I use it as a reference.

  • Just checking: have you seen this case, possibly this case, this case - close and this strange case. Is this what you're asking for? – anongoodnurse May 28 '15 at 6:26
  • @anongoodnurse was going through those now. Mostly seeing elevated DHEA-S as well which is freakishly missing here along with the pt being male. There's a chance I was going to answer this myself with a few of these. Or maybe I should just delete the question. – Atl LED May 28 '15 at 6:32
  • DHEA wasn't elevated in two of those, if I read correctly. The other two were less suitable, I agree. But they don't seem to be exceedingly rare - interestingly these were detected in women because of hirsuitism. How would they be detected in men? Aggression? – anongoodnurse May 28 '15 at 6:38
  • @anongoodnurse I completely missed that last one. I have a habit of working through my own Q&A in Bio.SE, which maybe I should avoid here. – Atl LED May 28 '15 at 6:39
  • Not at all. Makes for good questions. :-) If you're satisfied with those, I can write it up as an answer. – anongoodnurse May 28 '15 at 6:43
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These patients were all female, and the tumors are described as exceedingly rare. Were you looking for males?

https://www.ncbi.nlm.nih.gov/pubmed/14668717

METHODS: A retrospective chart review from January 1946 through November 2002 identified 11 female patients with pure androgen-secreting adrenal tumors.

RESULTS: The mean age was 23.4 years (range, 1-52). The most common presenting symptoms were hirsutism, acne, and clitoral enlargement. Elevated 17-ketosteroids were found in seven of nine tested patients. Computed tomogram, ultrasound, or both localized tumors in six of seven patients. All tumors were surgically resected, one laparoscopically, all without complications. Five of the 11 tumors were malignant. Mean weight and mean maximal diameter for benign and malignant tumors were 44 g and 4.2 cm and 232 g and 9.8 cm, respectively. Mean hospital stay was 8.5 days, with excess androgen production resolved in all patients. Recurrence and disease-related death occurred in only one patient who had pulmonary metastases at diagnosis. The remaining patients had no recurrence of tumor at mean follow-up of 11.7 years (range, 0.5-32 years).

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