Kono Takashi, Kono Satomi, Nakamura Yasuhiro, Fujii Yoichi, Sasano Hironobu, Tanaka Tomoaki
Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan.
Research Institute of Disaster Medicine, Chiba University, Chiba 260-8670, Japan.
JCEM Case Rep. 2025 Jul 31;3(9):luaf170. doi: 10.1210/jcemcr/luaf170. eCollection 2025 Sep.
A 17-year-old female softball player presented with progressive virilization and markedly enhanced athletic performance. Laboratory evaluation revealed elevated serum testosterone with autonomous adrenal secretion. Imaging analysis demonstrated an 8-cm right adrenal mass. Adrenalectomy was performed, and histopathological examination confirmed stage II adrenocortical carcinoma (ACC) with a Ki-67 labeling index of 14%. Postoperatively, she received adjuvant mitotane therapy. At 34 months, a solitary hepatic metastasis was successfully treated with radiofrequency ablation and combination chemotherapy. She has remained disease-free for more than 8 years following initial surgery. This case demonstrates the clinical impact of pathological hyperandrogenism on athletic performance and highlights the potential for long-term remission in young patients with aggressive ACC managed through multimodal therapy.
一名17岁的女性垒球运动员出现进行性男性化和运动表现显著增强。实验室检查显示血清睾酮升高，肾上腺自主分泌。影像学分析显示右侧肾上腺有一个8厘米的肿块。进行了肾上腺切除术，组织病理学检查证实为II期肾上腺皮质癌（ACC），Ki-67标记指数为14%。术后，她接受了米托坦辅助治疗。34个月时，通过射频消融和联合化疗成功治疗了孤立性肝转移。初次手术后，她已无病生存超过8年。该病例展示了病理性高雄激素血症对运动表现的临床影响，并突出了通过多模式治疗管理的侵袭性ACC年轻患者实现长期缓解的潜力。
