Normal delivery following resection of an androgen-secreting adrenal carcinoma
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CASE REPORT
Normal delivery following resection of an androgen-secreting adrenal carcinoma Toshiyasu Amano • Tetsuya Imao • Masaya Seki Katsurou Takemae • Keishi Yamauchi • Satoru Hata
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Received: 9 September 2010 / Accepted: 2 November 2010 / Published online: 26 November 2010 Ó Japan Society for Reproductive Medicine 2010
Abstract A 31-year-old female presented to a gynecological clinic complaining of amenorrhea and virilism over a 2-month period. Blood tests revealed high serum total testosterone and free testosterone levels. A left adrenal tumor was identified following computed tomography and she was referred to our clinic where a laparoscopic left adrenalectomy was performed. The tumor weighed 98 g and the pathological diagnosis according to Weiss’ criteria was adrenocortical carcinoma. The post-operative course was uneventful; her serum free testosterone level normalized and regular menstruation was observed 1 month postoperatively. The patient became pregnant 1 year later, resulting in the normal delivery of a girl.
characterized by a high malignant potential and a poor prognosis, e.g., mean survival times vary between 2.1 years for Stage I to 1.1 years for Stage IV [2]. However, the prognosis of androgen-secreting adrenal carcinomas is not grim in cases demonstrating the absence of invasion or metastasis, for example, in a study by Cordera et al., only one of five androgen-secreting adrenal cancer patients died after 29 months and the other four were still alive with no evidence of disease for 29–387 months [1]. We report the case of a 31-year-old female who experienced the normal delivery of a healthy child following the removal of an androgen-secreting adrenal carcinoma.
Keywords Adrenal cancer Androgen-secreting Pregnancy Delivery
Case report
Introduction Androgen-secreting adrenal tumors are extremely rare; moreover, many of these tumors are diagnosed as malignant disease [1]. In general, adrenocortical carcinoma is
T. Amano (&) T. Imao M. Seki K. Takemae Department of Urology, Nagano Red Cross Hospital, Wakasato 5-22-1, Nagano 380-8582, Japan e-mail: [email protected] K. Yamauchi Department of Metabolic and Endocrinology, Nagano Red Cross Hospital, Nagano, Japan S. Hata Department of Clinical Laboratory, Nagano Red Cross Hospital, Nagano, Japan
A 31-year-old female presented to a regional gynecological clinic complaining of amenorrhea and virilism over a 2-month period. Blood tests revealed low serum adrenocorticotropic hormone (ACTH) and high serum total testosterone and free testosterone levels. Consequently, she was referred to the Department of Metabolic and Endocrinology in our hospital for more detailed evaluation. Although elevated hemoglobin (15.9 g/dL) was detected, the results of additional blood tests were unremarkable (Table 1). Computed tomography (CT) disclosed a left adrenal tumor (6.0 9 6.0 9 5.5 cm) (Fig. 1). 131I-aldosterol scintigram SPECT (single-photon emission CT) identified high uptake of radioisotope by the left adrenal tumor (Fig. 2). Positron emi
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