Adrenal adenoma, virilizing

Pathogenesis of Diseases of the Sex Glands 488 Hereditary Diseases of the Sex Glands Inborn Errors of Corticosteroid Metabolism Adrenal Carcinoma Virilizing Adrenal Adenoma Stein-Leventhal Syndrome Steroid Metabolism in Liver Disease... 

The cortisol-androgen ratio of normal adrenals is 40 1 in adrenal carcinoma, this ratio is 1 3. Consequently, in adrenal adenomas or carcinomas, virilization rather than excessive glucocorticoid secretion occurs. 

A small virilizing adrenal adenoma producing testosterone and responsive to gonadotropin has been described [189]. 

Virilizing maternal tumors. These include adrenal adenoma, androblastoma, luteomas, and Kruken-berg tumors and are reported to cause fetal virilization. In cases of unclear hermaphroditism, evaluation of the mother should always include measurement of her plasma androgen levels. 

Adrenocortical Tumors. Virilization, hypercortisolism, feminization, abdominal pain, palpable abdominal tumor, or combinations of these features are clinical symptoms of adrenocortical tumors. Both types of adrenocortical tumors (carcinoma and adenoma) can produce a wide variety of steroid hormones. This is a consequence of multiple enzyme deficiencies in tumor tissues. The tumor cells are capable of synthesizing large amounts of steroid hormone precursors independent of ACTFI stimulation. Excessively high amounts of DHEA and other 3p hydroxy-5-ene steroids characterize the urinary steroid profile in children with adrenocortical carcinoma, but similar profiles can also be produced by adrenal adenomas. Elevated lip hydroxy-androsterone excretion alone or combined with high excretion of cortisol metabolites or 3p hydroxy-5-ene steroids are characteristic of the urinary steroid profile for adrenocortical adenomas [36,37]. 

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