A Unique Case of Isolated Dehydroepiandrosterone-Sulfate Secreting Adrenocortical Carcinoma: A Case Report with Review of the Literature

    October 2021 in “ Acta Scientific Medical Sciences ”
    Vijaya Ganta, Gail Nunlee-Bland, Terrence M. Fullum
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    TLDR A woman was diagnosed with a rare adrenal gland cancer that did not show usual hormone-related symptoms.
    A 52-year-old African American woman with a history of asthma was diagnosed with an isolated dehydroepiandrosterone-sulfate (DHEA-S) secreting adrenocortical carcinoma (ACC) after presenting with symptoms of an acute asthma exacerbation. Despite the absence of hyperandrogenic symptoms such as deepening voice, acne, or excessive hair growth, her endocrine workup revealed significantly elevated DHEA-S levels, with a repeat test confirming the increase. Imaging showed a 5.5 cm left adrenal mass, and subsequent open left adrenalectomy and histopathology confirmed the diagnosis of ACC, characterized by nuclear atypia, necrosis, and a high Ki-67 staining percentage. This case highlights that patients with isolated DHEA-S secreting ACC may not exhibit typical hyperandrogenic features.
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