Androsteroma

Androsteroma-one of the rare hormone-active tumors of the adrenal glands, is a virilizing tumor (a tumor in which there is "rejuvenation" – the appearance in women and the strengthening of male signs in men).  Androsteromas are 2 times more common in women than in men. Androsteromas are often found in the first year of life.

The tumor is localized either in one of the adrenal glands, or in the areas where additional adrenal tissue is located - in the ovaries or the broad uterine ligament. The tumor secretes a large amount of androgens, which determines the clinical picture. Androsteromas can be benign (adenomas) and malignant (carcinomas), but they can only be distinguished by examining the histological examination data. Tumors with a diameter of more than 5 cm, most often of a malignant nature, with metastases to the lungs, liver, lymph nodes of the retroperitoneal space and other organs. In childhood, virilizing tumors are usually malignant.

• What are the symptoms of Androsteroma?

At the heart of the clinical signs of the disease is the excessive production of androgens by the androsteroma - male sex hormones. Therefore, the symptoms of androsteroma are characterized by active "rejuvenation" - virilization. 

The degree of virilization in patients with androsteroma may be different, which is due to the individual characteristics of the hormonal activity of the tumor and the duration of the tumor process. 

Children develop premature sexual hair loss, impurity and greasiness of the skin, acne, muscle tissue buildup, hypertrichosis. In girls, the clitoris is virilized and enlarged at the normal entrance to the vagina, the mammary glands do not develop or hypoplasize, menstruation stops, and the voice becomes low. In boys, the penis increases in the absence of changes in the testicles, an erection appears.  In men, the clinical manifestations of virilization are less pronounced, so androsteroma can be an accidental finding. In children of both sexes, growth and skeletal maturation are accelerated. Sometimes hypertension is detected.

The general well-being of patients in the early stages of the disease does not change. Sometimes women note a surge of strength, an increase in efficiency, an increase in sexual desire. However, later patients become irritable, labile, and sometimes fall into a severe depressive state. When the tumor reaches an impressive size, compression of nearby nerve endings can lead to pain.

• Diagnosis Of Androsteroma.

The diagnosis of "androsteroma" is made on the basis of clinical signs, laboratory and instrumental diagnostic data, with careful differentiation of the disease with other pathological processes accompanied by virilization (for example, testicular or ovarian tumors, liver).

Currently, ultrasound, CT or MR tomography is widely used to detect the location of an adrenal tumor, the presence of metastases.

Laboratory examination of blood and urine in patients with androsteroma reveals a multiple increase in the concentration of androgens and their metabolites. Tests are performed with the introduction of adrenocorticotropic hormone and dexamethasone, for the purpose of differential diagnosis with congenital bilateral hyperplasia and adrenal dysfunction.

• Treatment of Androsteroma.

Surgical treatment-removal of the tumor along with the affected adrenal gland. In the case of metastases, the operation is combined with radiation and chemotherapy. In contrast to the treatment of corticosteroma, further hormone replacement therapy is usually not required, since the second adrenal gland does not undergo atrophy, and retains its function.

If a malignant androsteroma is diagnosed at a late stage, when distant metastases are detected, the treatment of the tumor is symptomatic (anesthesia, chemotherapy, radiation therapy), and the prognosis is unfavorable.

The prognosis for timely diagnosis and surgical correction of benign androstomas is favorable.