Adrenal cytomegaly with elevated serum androgen levels in a patient with Beckwith-Wiedemann syndrome.
Endocr J
; 69(8): 919-926, 2022 Aug 29.
Article
de En
| MEDLINE
| ID: mdl-35321987
ABSTRACT
Beckwith-Wiedemann syndrome (BWS) is infrequently associated with adrenocortical carcinoma (ACC) or non-hormone-producing adrenal cytomegaly, but we recently, encountered a single case of adrenal cytomegaly in a patient with BWS, which was difficult to distinguish from androgen-producing adrenocortical carcinoma (ACC). Here, we describe the case of a 4-month-old female who presented with clitoromegaly, hemihypertrophy, and an adrenal mass identified during the prenatal period. The mass was located in detected at the left suprarenal region and detected at 20 weeks of gestational age. At birth, she also presented with clitoromegaly and elevated serum levels of 17α-hydroxyprogesterone, dehydroepiandrosterone, and testosterone at birth and experienced hyper-insulinemic hypoglycemia, which improved following diazoxide therapy. We initially suspected androgen-producing ACC with metastasis and the left adrenal mass was resected accordingly when the patient reached 4 months of age. However, histological examination revealed adrenal cytomegaly. Genetic analysis revealed paternal uniparental disomy, and the patient was finally diagnosed as having BWS. Resection of the left adrenal gland restored the serum androgen levels to normal physiological levels without any recurrence. While it is reasonably well known that BWS is sometimes accompanied by virilization due to androgen-producing ACC, our findings are among the first to suggest that adrenal cytomegaly can also increase androgen hormone production. Thus, we propose that adrenal cytomegaly should be considered one of the differential diagnoses when accompanied with hyperandrogenism in BWS patients.
Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Syndrome de Beckwith-Wiedemann
/
Tumeurs corticosurrénaliennes
/
Maladies des surrénales
/
Carcinome corticosurrénalien
Type d'étude:
Prognostic_studies
Limites:
Female
/
Humans
/
Infant
/
Newborn
/
Pregnancy
Langue:
En
Journal:
Endocr J
Sujet du journal:
ENDOCRINOLOGIA
Année:
2022
Type de document:
Article
Pays d'affiliation:
Japon