Virilizing adrenal cortical neoplasm arising ectopically in the thorax

J Clin Endocrinol Metab. 1992 Dec;75(6):1522-5. doi: 10.1210/jcem.75.6.1464658.

Abstract

We describe a 44-yr-old woman with a 12-yr history of clinical virilization and serum testosterone levels up to 28.1 nmol/L (normal range, 1-3.3 nmol/L) in whom repeated clinical evaluation and surgical procedures failed to reveal the source of androgen production. At the time the patient was referred to the Clinical Center of the NIH, an intrathoracic mass was seen on upper cuts of an abdominal computer-aided tomography scan, confirmed by computer-aided tomography scan and magnetic resonance imaging of the chest. A 6 x 5 x 3.5-cm mass, attached to the posterior pericardium, was removed by thoracotomy. Pathological examination revealed an adrenal cortical neoplasm of uncertain malignant potential that contained testosterone, 11-deoxycortisol, progesterone, and 17-hydroxyprogesterone. After the operation, the patient's serum testosterone levels decreased to the normal range. Ectopic adrenal cortical rests in the thorax and neoplasms arising from these rests are extremely rare, and we are not aware of a similar case previously reported. In women with virilization, radiological studies of the thorax as well as other reported sites of ectopic adrenal cortex should be performed if radiological studies of the abdomen and pelvis fail to locate the source of the neoplasm.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Neoplasms / complications*
  • Adrenal Cortex Neoplasms / diagnostic imaging
  • Adrenal Cortex Neoplasms / pathology
  • Adult
  • Choristoma* / diagnostic imaging
  • Choristoma* / pathology
  • Choristoma* / surgery
  • Female
  • Humans
  • Radiography
  • Testosterone / blood
  • Thoracic Neoplasms* / diagnostic imaging
  • Thoracic Neoplasms* / pathology
  • Thoracic Neoplasms* / surgery
  • Virilism / blood
  • Virilism / etiology*

Substances

  • Testosterone