Isolated DHEA-S Production by an Adrenal Neoplasm: Clinical, Biochemical, and Pathologic Findings

The study described a rare case of an adrenal neoplasm in a 57-year-old post-menopausal woman that produced isolated dehydroepiandrosterone sulfate (DHEA-S) without elevating other androgens. The patient presented with a 4 cm right adrenal mass and generalized hair thinning but no other signs of virilization. Biochemical tests showed elevated DHEA-S levels (706 mcg/dL) while other androgens and adrenal hormones were normal. The mass was surgically removed, and post-operative tests confirmed a significant drop in DHEA-S levels, normalizing within three weeks. Pathology indicated a benign adrenal cortical neoplasm. This case highlighted the unique presentation and biochemical profile of a pure DHEA-S secreting adrenal adenoma.