Classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma: case report

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders related to adrenal steroid biosynthesis, and mainly caused by mutations in the CYP21A2 gene encoding 21-hydroxylase. Adrenal tumors are common in CAH, but functional adrenal tumors are rare. Here, we report a 17-year-ol...

Full description

Saved in:
Bibliographic Details
Main Authors: Qin Yan, Huancheng Su, Xuan Jing, Sufen Li, Xujiao Ji, Zhiping Zhang, Yanni Wang, Xia Huang, Tingting Xue, Xueqing Wu, Xiangrong Cui
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Gynecological Endocrinology
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/09513590.2024.2373741
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850104276720812032
author Qin Yan
Huancheng Su
Xuan Jing
Sufen Li
Xujiao Ji
Zhiping Zhang
Yanni Wang
Xia Huang
Tingting Xue
Xueqing Wu
Xiangrong Cui
author_facet Qin Yan
Huancheng Su
Xuan Jing
Sufen Li
Xujiao Ji
Zhiping Zhang
Yanni Wang
Xia Huang
Tingting Xue
Xueqing Wu
Xiangrong Cui
author_sort Qin Yan
collection DOAJ
description Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders related to adrenal steroid biosynthesis, and mainly caused by mutations in the CYP21A2 gene encoding 21-hydroxylase. Adrenal tumors are common in CAH, but functional adrenal tumors are rare. Here, we report a 17-year-old female with virilized external genitalia and primary amenorrhea, accompanied by a right adrenal tumor. Her 17-OHP level was normal, cortisol and androgen levels were significantly elevated, and the tumor pathology showed adrenal cortical adenoma. Gene testing for CYP21A2 showed c.518T > A in exon 4 and c.29313C > G in intron 2. The possibility of untreated classic CAH with 21-OH deficiency causing functional adrenal cortical adenoma should be considered. When clinical diagnosis highly considers CAH and cannot rule out the influence of functional adrenal tumors’ secretion function on 17-OHP, gene mutation analysis should be performed.
format Article
id doaj-art-2b9d6f6df8d848ff8d8ba3895eb3507f
institution DOAJ
issn 0951-3590
1473-0766
language English
publishDate 2024-12-01
publisher Taylor & Francis Group
record_format Article
series Gynecological Endocrinology
spelling doaj-art-2b9d6f6df8d848ff8d8ba3895eb3507f2025-08-20T02:39:22ZengTaylor & Francis GroupGynecological Endocrinology0951-35901473-07662024-12-0140110.1080/09513590.2024.2373741Classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma: case reportQin Yan0Huancheng Su1Xuan Jing2Sufen Li3Xujiao Ji4Zhiping Zhang5Yanni Wang6Xia Huang7Tingting Xue8Xueqing Wu9Xiangrong Cui10Reproductive Medicine Center, The affiliated Children’s Hospital of Shanxi Medical University, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, Shanxi, P.R.ChinaFirst Hospital of Shangxi Medical University, Taiyuan, Shanxi, P.R. ChinaDepartment of Clinical Laboratory, Shanxi Provincial People’s Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, P.R.ChinaFirst Hospital of Shangxi Medical University, Taiyuan, Shanxi, P.R. ChinaFirst Hospital of Shangxi Medical University, Taiyuan, Shanxi, P.R. ChinaFirst Hospital of Shangxi Medical University, Taiyuan, Shanxi, P.R. ChinaDepartment of Clinical Laboratory, Shanxi Provincial People’s Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, P.R.ChinaDepartment of Clinical Laboratory, Shanxi Provincial People’s Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, P.R.ChinaDepartment of Clinical Laboratory, Shanxi Provincial People’s Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, P.R.ChinaReproductive Medicine Center, The affiliated Children’s Hospital of Shanxi Medical University, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, Shanxi, P.R.ChinaReproductive Medicine Center, The affiliated Children’s Hospital of Shanxi Medical University, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, Shanxi, P.R.ChinaCongenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders related to adrenal steroid biosynthesis, and mainly caused by mutations in the CYP21A2 gene encoding 21-hydroxylase. Adrenal tumors are common in CAH, but functional adrenal tumors are rare. Here, we report a 17-year-old female with virilized external genitalia and primary amenorrhea, accompanied by a right adrenal tumor. Her 17-OHP level was normal, cortisol and androgen levels were significantly elevated, and the tumor pathology showed adrenal cortical adenoma. Gene testing for CYP21A2 showed c.518T > A in exon 4 and c.29313C > G in intron 2. The possibility of untreated classic CAH with 21-OH deficiency causing functional adrenal cortical adenoma should be considered. When clinical diagnosis highly considers CAH and cannot rule out the influence of functional adrenal tumors’ secretion function on 17-OHP, gene mutation analysis should be performed.https://www.tandfonline.com/doi/10.1080/09513590.2024.2373741Congenital adrenal hyperplasiavirilismCYP21A2adrenocortical adenomagenetic testing
spellingShingle Qin Yan
Huancheng Su
Xuan Jing
Sufen Li
Xujiao Ji
Zhiping Zhang
Yanni Wang
Xia Huang
Tingting Xue
Xueqing Wu
Xiangrong Cui
Classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma: case report
Gynecological Endocrinology
Congenital adrenal hyperplasia
virilism
CYP21A2
adrenocortical adenoma
genetic testing
title Classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma: case report
title_full Classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma: case report
title_fullStr Classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma: case report
title_full_unstemmed Classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma: case report
title_short Classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma: case report
title_sort classic congenital adrenal hyperplasia with unilateral functional adrenal cortical adenoma case report
topic Congenital adrenal hyperplasia
virilism
CYP21A2
adrenocortical adenoma
genetic testing
url https://www.tandfonline.com/doi/10.1080/09513590.2024.2373741
work_keys_str_mv AT qinyan classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT huanchengsu classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT xuanjing classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT sufenli classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT xujiaoji classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT zhipingzhang classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT yanniwang classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT xiahuang classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT tingtingxue classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT xueqingwu classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport
AT xiangrongcui classiccongenitaladrenalhyperplasiawithunilateralfunctionaladrenalcorticaladenomacasereport