Androsteroma is a hormone-active tumor of the adrenal cortex, originating mainly from its reticular zone, excessively secreting corticosteroids, but mainly androgens, and characterized by a clinical picture similar to congenital dysfunction of the adrenal cortex. The disease can occur at any age in persons of both sexes.
Etiology. The cause of the disease is unknown.
Pathogenesis. The pathogenesis of androsteroma is caused by an increase in the production of hormones, mainly androgens, and tumor tissue.
Pathological anatomy. A pathoanatomical study reveals a tumor of the adrenal cortex. Usually it is soft consistency, encapsulated. Histologically, mainly dark cells characterized by pronounced polymorphism are detected in the tumor. In some cases, the histological picture of the tumor resembles the structure of the reticular zone of the adrenal cortex. In the case of malignant androsterome, pronounced polymorphism, cell atypia, infiltrative growth of tumor cells, and many foci of necrosis are noted. In case of malignant androsterome, metastasis can occur in the abdominal cavity, liver, lungs.
Clinic. The clinic of androsteroma is in many respects similar to congenital dysfunction of the adrenal cortex, however, it is characterized by the rapid development of virilization, especially abrupt with malignant androsterome. Occasionally, individual symptoms occur inherent in Itsenko-Cushing’s disease, which is caused by hyperproduction by glucocorticoids.
Radioisotope diagnosis of the adrenal glands. Radiodiagnosis. On the scintigraphy and radiograph, one-sided adrenal tumor is detected.
Diagnostic tests * In the presence of androsteroma after taking corticosteroid drugs (dexamethasone orally 2 mg every 6 hours for 2 days or other drugs), the excretion of 17-COP with urine does not change.
Diagnosis and differential diagnosis. X-ray diagnostics of the adrenal glands are of crucial importance when making a diagnosis of androsteroma. Differential diagnosis of diseases – see “Congenital virilizing hyperplasia of the cortex over the kidneys”.
Forecast. With early diagnosis and timely surgical treatment of benign androsteroma, the prognosis is favorable. In case of malignant androsterome and the presence of metastases, the prognosis is favorable.
Treatment. Treatment is only operative – removal of the adrenal gland affected by the tumor.