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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
Special laboratory:
- 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 (CT of abdomen)
Differential diagnosis:
- polycystic ovary syndrome
- Cushing syndrome
- abnormal dexamethasone suppression test
General
endocrine neoplasm
References
- Medical Knowledge Self Assessment Program (MKSAP) 18,
American College of Physicians, Philadelphia 2018
- Medical Knowledge Self Assessment Program (MKSAP) 20
American College of Physicians, Philadelphia 2025
- Hirschberg AL.
Approach to investigation of hyperandrogenism in a postmenopausal woman.
J Clin Endocrinol Metab. 2023;108:1243-1253.
PMID: 36409990