Mantiri Ben Julian, Sigumonrong Yacobda
Urology Resident of Urology Department, Faculty of Medicine, Universitas Indonesia - H. Adam Malik Hospital, Medan, Indonesia.
Urology Consultant of Urology Department, Faculty of Medicine, Universitas Indonesia - H. Adam Malik Hospital, Medan, Indonesia.
Int J Surg Case Rep. 2021 Jul;84:106134. doi: 10.1016/j.ijscr.2021.106134. Epub 2021 Jun 25.
A bilateral adrenal tumor is a rare case. It differs significantly from unilateral adrenal mass since it is related strongly to genetic and family history. Adrenocortical Carcinoma might cause related hormonal syndromes such as Cushing syndrome, Conn syndrome, and virilization.
This study aims to report an uncommon presentation of a 15-year-old female with bilateral Adrenal Tumor since an early age with virilization as the main symptoms.
The patient is a 15-year-old girl with female genitalia presentation. She complained of a bulging mass on her right flank with pain four years ago. The mass size grew progressively and initially painless. However, the patient started to feel pain a year ago. Since she was six years old, the mass started to appear on the left flank, and then it also started to appear on the right side. The mass appearance is simultaneous with virilization symptom development, such as the emergence of facial hair, mustache, and sideburns. In 2020, MRI showed a lesion on the right suprarenal with contrast enhancement with 14.5 × 11.5 cm in size, and a 5.6 × 4 cm recurrent left suprarenal lesion. The patient underwent right adrenalectomy resection surgery on January 21st, 2021. The immunohistochemistry examination suggested Adrenocortical Carcinoma.
Adrenocortical Carcinoma is a hormone-secreting tumor that might affect the patient's condition systematically. Neglected cases of adrenal cortical carcinoma might affect secondary sexual organ development in the long term. Thus, an early diagnosis and treatment are paramount for this case.
双侧肾上腺肿瘤是一种罕见病例。它与单侧肾上腺肿块有显著差异,因为它与遗传和家族史密切相关。肾上腺皮质癌可能会引发相关的激素综合征,如库欣综合征、原发性醛固酮增多症和男性化。
本研究旨在报告一名15岁女性自幼患有双侧肾上腺肿瘤并以男性化为主要症状的罕见病例。
该患者为一名具有女性生殖器表现的15岁女孩。她四年前主诉右侧胁腹有一隆起肿块并伴有疼痛。肿块大小逐渐增大,起初无痛。然而,患者一年前开始感到疼痛。自六岁起,肿块开始出现在左侧胁腹,随后右侧也开始出现。肿块出现的同时伴有男性化症状的发展,如面部毛发、胡须和鬓角的出现。2020年,磁共振成像显示右侧肾上腺有一病变,增强扫描后大小为14.5×11.5厘米,左侧肾上腺有一5.6×4厘米的复发病变。患者于2021年1月21日接受了右肾上腺切除术。免疫组化检查提示为肾上腺皮质癌。
肾上腺皮质癌是一种分泌激素的肿瘤,可能会系统性地影响患者病情。肾上腺皮质癌被忽视的病例长期可能会影响第二性征器官的发育。因此,对于该病例,早期诊断和治疗至关重要。