Testosterone-Secreting Adrenal Adenoma That Contained Crystalloids of Reinke in an Adult Female Patient

This case study described a 55-year-old woman with virilization symptoms due to a testosterone-secreting adrenal adenoma containing crystalloids of Reinke, which are characteristic of Leydig cells. Her serum testosterone was significantly elevated despite normal levels of other adrenal androgens. Surgical removal of the right adrenal gland normalized her testosterone levels, which remained stable for 2 years. The study supported the hypothesis that Leydig cells, typically found in the testes, can be present in the adrenal gland and contribute to testosterone-secreting adrenal tumors. It emphasized considering adrenal tumors in cases of virilization with elevated testosterone but normal levels of other adrenal androgens. This was the fourth reported case of such adenomas, suggesting that Leydig cells might be present in the adrenal gland due to ectopic deposition or adrenal gonadostromal metaplasia. The study also noted that the absence of crystalloids of Reinke does not rule out a Leydig cell character, as these inclusions are found in only 40% of Leydig cell tumors of the testis.