Pure Androgen-Secreting Adrenal Adenoma Associated with Resistant Hypertension

Abstract EN

Pure androgen-secreting adrenal adenoma is very rare, and its diagnosis remains a clinical challenge.

Its association with resistant hypertension is uncommon and not well understood.

We present an 18-year-old female with a 10-year history of hirsutism that was accidentally diagnosed with an adrenal mass during the evaluation of a hypertensive crisis.

She had a long-standing history of hirsutism, clitorimegaly, deepening of the voice, and primary amenorrhea.

She was phenotypically and socially a male.

FSH, LH, prolactin, estradiol, 17-hydroxyprogesterone, and progesterone were normal.

Total testosterone and DHEA-S were elevated.

Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonclassic congenital adrenal hyperplasia were ruled out.

She underwent adrenalectomy and pathology reported an adenoma.

At 2-month followup, hirsutism and virilizing symptoms clearly improved and blood pressure normalized without antihypertensive medications, current literature of this unusual illness and it association with hypertension is presented and discussed.