A Pure Androgen-Secreting Adrenal Cortical Tumor in a 13-Year-Old Female

A 13-year-old female presented with virilization symptoms, including a deep masculine voice, hirsutism, and elevated androgen levels, due to a rare androgen-secreting adrenal cortical adenoma. Initial lab results showed significantly elevated levels of 17-Hydroxypregnenolone, Androstenedione, Testosterone, DHEA, and DHEA-S, with normal LH, FSH, Estradiol, Cortisol, and Chromogranin A. Imaging revealed a large left adrenal mass, which was surgically removed. The pathology confirmed a Stage II adrenal cortical adenoma with a slightly increased ki67 index. Post-operatively, the patient's symptoms improved, including the resumption of regular menstrual periods, and normalization of DHEA-S levels. This case is notable as one of the first documented instances of a pure androgen-secreting adrenal cortical tumor in a pediatric patient without Cushing's syndrome symptoms.