androgen-secreting tumor

Etiology

• ovarian neoplasm
• adrenal neoplasm
  • adrenal cortical ademoma
  • adrenal cortical carcinoma

Epidemiology

• rare
• postmenopausal women

Pathology

• can arise in ovaries or adrenal glands

Clinical manifestations

• voice deepening
• clitoromegaly
• male pattern baldness
• severe acne
• hirsutism (virilism)
• temporal balding
• Cushingoid features if concomitant cortisol secretion

Laboratory

• serum testosterone elevated
• serum DHEA sulfate elevated
  • serum DHEA sulfate > 700 ug/dL suggest an adrenal neoplasm
    • serum DHEA sulfate > 800 ug/dL suggest an adrenal carcinoma

Diagnostic procedures

• normal overnight low-dose (1-mg) dexamethasone suppression test
• if both pelvic transvaginal ultrasound & CT of adrenal glands are unremarkable, consider ovarian vein sampling & adrenal vein sampling

Radiology

• pelvic transvaginal ultrasound
• CT of adrenal glands

Differential diagnosis

• polycystic ovary syndrome
• Cushing syndrome
  • abnormal dexamethasone suppression test

More general terms

• endocrine neoplasm