Steroid metabolites producing adenoma: a case report
Hyperandrogenism is the most prevalent cause of menstrual cycle abnormalities and infertility in women. Here, we present a case of a 32-year-old woman with a 7-year history of menstrual irregularity and infertility. Laboratory test results revealed elevated 17-hydroxyprogesterone, progesterone 21-de...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Endocrinology Research Centre
2024-01-01
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| Series: | Ожирение и метаболизм |
| Subjects: | |
| Online Access: | https://www.omet-endojournals.ru/jour/article/view/13050 |
| _version_ | 1797204541503963136 |
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| author | K. V. Ivashchenko K. A. Komshilova N. V. Molashenko A. A. Lavreniuk A. M. Lapshina I. V. Kim V. A. Ioutsi M. A. Antsupova M. V. Utkina N. M. Platonova E. A. Troshina N. G. Mokrysheva |
| author_facet | K. V. Ivashchenko K. A. Komshilova N. V. Molashenko A. A. Lavreniuk A. M. Lapshina I. V. Kim V. A. Ioutsi M. A. Antsupova M. V. Utkina N. M. Platonova E. A. Troshina N. G. Mokrysheva |
| author_sort | K. V. Ivashchenko |
| collection | DOAJ |
| description | Hyperandrogenism is the most prevalent cause of menstrual cycle abnormalities and infertility in women. Here, we present a case of a 32-year-old woman with a 7-year history of menstrual irregularity and infertility. Laboratory test results revealed elevated 17-hydroxyprogesterone, progesterone 21-deoxycortisol. Abdominal computed tomography found a 3,9х2,9х2,6 cm left adrenal tumor. Non-classic congenital adrenal hyperplasia was diagnosed initially, however, treatment with supraphysiological doses of dexamethasone proved ineffective and progesterone and 17-hydroxyprogesterone levels remained high. Genetic testing revealed no 21-hydroxylase deficiency. Laparoscopic adrenalectomy was performed with subsequent pathological report being compatible with an adrenal cortical adenoma. 17-hydroxyprogesterone, progesterone 21-deoxycortisol levels returned to the normal range postoperatively and the patient’s menstrual cycle normalized without additional medication. Steroid metabolites producing adenomas are also extremely rare with only a few cases found in patients without previous CAH diagnosis. When a patient with clinically and biochemically diagnosed NCCAH demonstrate no typical features and shows poor response to steroid therapy, the patient should receive multisteroid LC–MS/MS assay for glucocorticoids and androgens, adrenal and ovarian imaging and undergo CYP21A2 gene mutation analysis. |
| first_indexed | 2024-03-08T09:12:20Z |
| format | Article |
| id | doaj.art-87861a79039b46e1aeee5377fbf9576e |
| institution | Directory Open Access Journal |
| issn | 2071-8713 2306-5524 |
| language | English |
| last_indexed | 2024-04-24T08:36:52Z |
| publishDate | 2024-01-01 |
| publisher | Endocrinology Research Centre |
| record_format | Article |
| series | Ожирение и метаболизм |
| spelling | doaj.art-87861a79039b46e1aeee5377fbf9576e2024-04-16T16:16:15ZengEndocrinology Research CentreОжирение и метаболизм2071-87132306-55242024-01-0120436337010.14341/omet1305011001Steroid metabolites producing adenoma: a case reportK. V. Ivashchenko0K. A. Komshilova1N. V. Molashenko2A. A. Lavreniuk3A. M. Lapshina4I. V. Kim5V. A. Ioutsi6M. A. Antsupova7M. V. Utkina8N. M. Platonova9E. A. Troshina10N. G. Mokrysheva11Endocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreHyperandrogenism is the most prevalent cause of menstrual cycle abnormalities and infertility in women. Here, we present a case of a 32-year-old woman with a 7-year history of menstrual irregularity and infertility. Laboratory test results revealed elevated 17-hydroxyprogesterone, progesterone 21-deoxycortisol. Abdominal computed tomography found a 3,9х2,9х2,6 cm left adrenal tumor. Non-classic congenital adrenal hyperplasia was diagnosed initially, however, treatment with supraphysiological doses of dexamethasone proved ineffective and progesterone and 17-hydroxyprogesterone levels remained high. Genetic testing revealed no 21-hydroxylase deficiency. Laparoscopic adrenalectomy was performed with subsequent pathological report being compatible with an adrenal cortical adenoma. 17-hydroxyprogesterone, progesterone 21-deoxycortisol levels returned to the normal range postoperatively and the patient’s menstrual cycle normalized without additional medication. Steroid metabolites producing adenomas are also extremely rare with only a few cases found in patients without previous CAH diagnosis. When a patient with clinically and biochemically diagnosed NCCAH demonstrate no typical features and shows poor response to steroid therapy, the patient should receive multisteroid LC–MS/MS assay for glucocorticoids and androgens, adrenal and ovarian imaging and undergo CYP21A2 gene mutation analysis.https://www.omet-endojournals.ru/jour/article/view/13050infertility17-hydroxyprogesteronecongenital adrenal hyperplasiaadrenal tumorhyperandrogenism |
| spellingShingle | K. V. Ivashchenko K. A. Komshilova N. V. Molashenko A. A. Lavreniuk A. M. Lapshina I. V. Kim V. A. Ioutsi M. A. Antsupova M. V. Utkina N. M. Platonova E. A. Troshina N. G. Mokrysheva Steroid metabolites producing adenoma: a case report Ожирение и метаболизм infertility 17-hydroxyprogesterone congenital adrenal hyperplasia adrenal tumor hyperandrogenism |
| title | Steroid metabolites producing adenoma: a case report |
| title_full | Steroid metabolites producing adenoma: a case report |
| title_fullStr | Steroid metabolites producing adenoma: a case report |
| title_full_unstemmed | Steroid metabolites producing adenoma: a case report |
| title_short | Steroid metabolites producing adenoma: a case report |
| title_sort | steroid metabolites producing adenoma a case report |
| topic | infertility 17-hydroxyprogesterone congenital adrenal hyperplasia adrenal tumor hyperandrogenism |
| url | https://www.omet-endojournals.ru/jour/article/view/13050 |
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