![]() Generally small (average <4 cm) and unilateral, they are very common and found in approximately 10% of postmortem exams. The vast majority of adrenal tumors are benign, hormonally inactive adenomas, often found by accident. These tumors are extremely rare, with an incidence of only 0.5 to 2 per one million persons per year. The most common presentation is hypercortisolism, though virilization can occur due to secretion of excess androgens. Briefly, in terms of the adrenal, approximately 60% of adrenocortical carcinomas present with symptoms of hormone excess. Īndrogen-secreting tumors can also arise in the adrenal gland. Ovarian tumors account for only 0.2% of cases of hyperandrogenism. Androgen-secreting tumors, however, are an extremely rare cause of this disorder and tend to receive a disproportionate share of attention in the differential diagnosis. Hyperandrogenism affects 7% of women and can be both physically and psychologically disturbing. While true, statistically, this was probably the least likely etiology. When I would ask the presenter for a differential diagnosis, almost always, one of the first responses would be that she could have an androgen-secreting tumor. ![]() As the attending physician covering the resident gynecology clinic, it was not unusual for a student or a resident to present the case of a woman complaining of hirsutism. ![]()
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