Feminizing adrenocortical adenoma presenting as heterosexual precocious puberty: report of one case.
We report on a case of a 2 2/12-year-old boy with heterosexual precocious puberty secondary to a feminizing adrenocortical adenoma. The boy, with no previous history of disease or treatment, presented with bilateral gynecomastia and pubic hair development (Tanner III breasts and Tanner II pubic hair). Plasma estradiol and testosterone were 410.9 pg/ml and 126.2 ng/dl respectively. Basal plasma LH and FSH levels were within the normal range. Bolus i.v. injection of GnRH showed unresponsiveness of LH and FSH. Abdominal echography and abdominal magnetic resonance imaging revealed a well-defined mass at the left suprarenal region (measuring 4.0 x 2.7 x 3.6 cm in size). After removal of the adrenal tumor, the estradiol and testosterone levels fell to normal in 2 weeks. The gynecomastia and pubic hair regressed with time. The pathology of the tumor showed compact pattern with polygonal cells containing moderate eosinophilic cytoplasm without mitotic figure. These findings were consistent with an adrenocortical adenoma secreting estradiol and testosterone as the cause of the patient's heterosexual precocious puberty.
Hsiao
Hui-Pin
HP
Department of Pediatrics, Kaohsiung Municipal Hsiao Kang Hospital, Taiwan.
Chao
Mei-Chyn
MC
Lin
Chao-Yu
CY
Chen
Hsiu-Lin
HL
Chen
Shiu-Lin
SL
Chiou
Shyh-Shin
SS
Chen
Bai-Hsiun
BH
D000005:Abdomen / Q000473:pathology / Q000601:surgery; D000306:Adrenal Cortex Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D018246:Adrenocortical Adenoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000365:Age Determination by Skeleton; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002675:Child, Preschool; D004958:Estradiol / Q000097:blood; D006177:Gynecomastia / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011629:Puberty, Precocious / Q000209:etiology* / Q000473:pathology; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome
D013739:Testosterone; D004958:Estradiol