Asian Journal of Case Reports in Surgery

A Case Report on Virilizing Adrenal Tumor

Shikhil Puzhakkal

Endocrine Surgery Department, Baby Memorial Hospital, Kozhikode, Kerala, India.

Niya Narayanan

Medical Endocrinology Department, Baby Memorial Hospital, Kozhikode, Kerala, India.

Ani Praveen

Pathology Department ,Baby Memorial Hospital, Kozhikode, Kerala, India.

Pradeep Puthen Veetil *

Endocrine Surgery Department, Baby Memorial Hospital, Kozhikode, Kerala, India.

*Author to whom correspondence should be addressed.

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Abstract

Objective: To discuss a rare case of virilizing Oncocytoma of Adrenal Gland.

Background: Hirsutism is a common problem affecting 5-10% of the general population. It causes immense psychological burden. The commonest cause of hirsutism is poly cystic ovary syndrome (PCOS). It is seen in 3 out of 4 hirsute women. Sometimes it will be due to rare endocrine diseases like Cushing’s syndrome or non- classical congenital adrenal hyperplasia or androgen secreting ovarian tumor and adrenal tumors.

Presentation: we report a 49 Year old lady who presented with hirsutism and virilization features to the Dermatology department. On further hormonal evaluation, she was found to have an elevated Di hydro epiandrosterone - sulfate (DHEA-S). Computerized Tomography (CT) of abdomen was done which showed 45x35x38 mm right adrenal mass. She underwent open right adrenalectomy and histopathology was suggestive of adrenal oncocytoma, a rare adrenal tumor. Functional adrenal oncocytoma is very rare in literature and it is valuable to report.

Conclusion: Adrenal oncocytomas are rare tumors which are commonly present as adrenal incidentalomas. Only histopathology can diagnose oncocytomas and its clinical behaviour. Treatment of choice is excision as open or laparoscopic adrenalectomy. As there are no clear cut guidelines for follow up, it needs further studies and high levels of evidence.

Keywords: Hirsutism, virilization, DHEA-S, adrenal oncocytoma

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