We present a case of an adolescent with an adrenocortical carcinoma that demonstrates the potential inhibitory effects of androgens on breast and endometrial development.
A previously well 14½ year old girl presented with a two year history of worsening hirsutism and abdominal pain. She had onset of pubarche at 11 years, but had not yet had breast development or menarche. In contrast, her mother and sister had menarche at 12 and 11 years of age, respectively. On examination her height was 150.4 cm (3rd percentile) and weight 57.3 kg (50th percentile). She had a deep voice, muscular build, and hirsutism involving her upper lip, chin, chest and lower back. There were no features suggestive of glucocorticoid excess. She was Tanner stage 1 for breast and 5 for pubic hair. The remainder of the examination was unremarkable.
Written by:
Harrington J, Palmert MR. Are you the author?
Division of Endocrinology, The Hospital for Sick Children and Departments of Pediatrics and Physiology, The University of Toronto, Toronto, Canada.
Reference: Clin Endocrinol (Oxf). 2012 Aug 24. Epub ahead of print.
doi: 10.1111/cen.12021
PubMed Abstract
PMID: 22924578
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