AN UNUSUAL CASE OF BILATERAL VIRILIZING ADRENAL ADENOMA CO-SECRETING ANDROGENS AND CORTISOL

We report the case of a 68-year-old woman presenting with clinical and biochemical evidence of hyperandrogenism. Imaging studies revealed th e presence of a bilateral adrenal tumor. Although there was a predomin ant secretion of androgens, autonomous production of cortisol was also evidenced on the basis of an inversion of the circadian rhythm of pla sma cortisol and an absence of cortisol suppression by dexamethasone. The functional status of both tumors was demonstrated by an iodocholes terol scintigraphy and by an adrenal vein catheterization. Surgical ex cision of both adrenal tumors was performed and histological examinati on disclosed no criteria of malignancy, The patient still remains dise ase-free 3 years after surgery, To our knowledge, this is the second r eport of the bilateral occurrence of a virilizing adrenal tumor and th e first in which the functional characteristics of the tumors are deta iled.