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Cardiology65 papers

Virilizing adrenal tumor

Last edited: 4/14/2026

Overview

Virilizing adrenal tumors are rare neoplasms that produce androgens leading to virilization symptoms, often mimicking other adrenal disorders. These tumors can be functional or nonfunctional and require surgical intervention for definitive management 2021.

Diagnosis

  • Clinical Presentation: Virilization symptoms such as hirsutism, clitoromegaly, and amenorrhea in females; ambiguous genitalia in infants 21.
  • Imaging: CT and MRI are crucial for tumor characterization; characteristic appearances can differentiate myelolipomas from other tumors 202324.
  • Biochemical Testing: Elevated androgen levels (e.g., testosterone, DHEA-S) confirm the diagnosis 21.
  • Histopathology: Definitive diagnosis often requires surgical resection and histopathological examination 2021.

    • Management

  • Surgical Resection: Laparoscopic or robotic adrenalectomy is preferred for most cases 179.
  • Preoperative Imaging: Utilize 18F-FDG PET/CT for differentiating benign from malignant tumors when imaging findings are inconclusive 3.
  • Postoperative Monitoring: Regular follow-up with hormonal assessments to monitor recurrence 21.

    • Special Populations

  • Pediatrics: Adrenal cortical tumors in children require careful evaluation and management due to potential malignancy 26.
  • Elderly: Consider comorbidities and surgical risk when planning adrenalectomy 9.

    • Key Recommendations

  • Surgical Intervention: Laparoscopic adrenalectomy is recommended as the first-line treatment for virilizing adrenal tumors due to favorable outcomes 179 (Evidence: Strong).
  • Preoperative Imaging: Use advanced imaging techniques like 18F-FDG PET/CT to aid in tumor characterization and guide surgical planning 3 (Evidence: Moderate).
  • Comprehensive Follow-Up: Post-surgical monitoring with hormonal assessments is essential to detect recurrence early 21 (Evidence: Moderate).

    • References

    1 Berber E, Ibrahimli A, Memisoglu E, Akgun E, Perez-Soto R. Laparoscopic Versus Robotic Adrenalectomy: A Randomized Clinical Trial. Annals of surgical oncology 2026. link 2 Sojat AS, Rance B, Neuraz A, Fassnacht M, Beuschlein F, Robledo M et al.. How ready are endocrine scientists to share retrospective clinical data for research: a perspective from the European Network for the Study of Adrenal Tumors. European journal of endocrinology 2025. link 3 Schaafsma M, Berends AMA, Links TP, Brouwers AH, Kerstens MN. The Diagnostic Value of 18F-FDG PET/CT Scan in Characterizing Adrenal Tumors. The Journal of clinical endocrinology and metabolism 2023. link 4 Zuo ZB, Zhang Q, Wu WX, Li X, Zhang L, Wang JY et al.. Primary adrenal anastomosing haemangioma. Endokrynologia Polska 2023. link 5 Xu J, Tian F, Wang L, Miao Z. Binary Particle Swarm Optimization Intelligent Feature Optimization Algorithm-Based Magnetic Resonance Image in the Diagnosis of Adrenal Tumor. Contrast media & molecular imaging 2022. link 6 Introini C, Campodonico F, Ennas M, Di Domenico A, Foppiani L. Non-secreting adrenal myelolipoma in a middle-aged male patient manifesting with sudden onset of severe lower back pain. Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica 2020. link 7 Taskin HE, Siperstein A, Mercan S, Berber E. Laparoscopic posterior retroperitoneal adrenalectomy. Journal of surgical oncology 2012. link 8 Monsefi N, Dehghani M, Nowshadi PA, Mirkharrazi SM, Karimi A, Dabiri S. Leiomyoma of the adrenal gland presenting as an incidentaloma. Archives of Iranian medicine 2011. link 9 Guerrieri M, Campagnacci R, De Sanctis A, Baldarelli M, Coletta M, Perretta S. The learning curve in laparoscopic adrenalectomy. Journal of endocrinological investigation 2008. link 10 Garg S, Mathew M, Goel T. Adrenal schwannoma: a case report and review of literature. Indian journal of pathology & microbiology 2007. link 11 Van Dyck P, Op de Beeck B, Parizel PM. Helical CT and dynamic Mr features of an adrenal ganglioneuroma. JBR-BTR : organe de la Societe royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR) 2006. link 12 Répássy DL, Csata S, Sterlik G, Iványi A. Giant adrenal myelolipoma. Pathology oncology research : POR 2001. link 13 Waters PR, Haselhuhn GD, Gunning WT, Phillips ER, Selman SH. Adrenocortical oncocytoma: two case reports and review of literature. Urology 1997. link00543-2) 14 Kobayashi T, Kubota Y, Sasagawa I, Suzuki H, Sanjoh Y, Yaguchi H et al.. Adrenal myelolipoma with abdominal pain. Urologia internationalis 1997. link 15 Goldman RL, Brodey PA. Symptomatic leiomyoma of the adrenal. International urology and nephrology 1993. link 16 Kato T, Nakada T, Sasagawa I, Yaguchi H, Suzuki H, Yamaguchi T. Cystic adrenal mass: pseudocyst associated with hemangioma. Urologia internationalis 1993. link 17 Salup R, Finegold R, Borochovitz D, Boehnke M, Posner M. Cavernous hemangioma of the adrenal gland. The Journal of urology 1992. link37149-5) 18 Decorato JW, Gruber H, Petti M, Levowitz BS. Adrenal carcinosarcoma. Journal of surgical oncology 1990. link 19 Prinz RA. Mobilization of the right lobe of the liver for right adrenalectomy. American journal of surgery 1990. link81230-9) 20 Moskovitz B, Bolkier M, Katz Y, Ben Arieh Y, Richter Levin D. Adrenal myelolipoma simulating virilizing adrenal tumor. Urologia internationalis 1989. link 21 Pardo JM. Virilization of a female infant due to an adrenal tumor. Clinical pediatrics 1986. link 22 Auh YH, Anand J, Zirinsky K, Kazam E. Adrenal hemangioma: a case report. The Journal of computed tomography 1986. link90012-3) 23 Hanafy HM. Myelolipoma of the adrenal gland. European urology 1981. link 24 Athani VS, Mulholland SG. Primary nonfunctioning adrenal tumors in adults. Urology 1981. link90421-0) 25 Snearly RG, Ram MD. Myelolipoma of adrenal. Urology 1978. link90247-9) 26 Zaitoon MM, Mackie GG. Adrenal cortical tumors in children. Urology 1978. link90424-7) 27 Rothberg M, Bastidas J, Mattey WE, Bernas E. Adrenal hemangiomas: angiographic appearance of a rare tumor. Radiology 1978. link 28 Glaister JR, Samuels DM, Tucker MJ. Ganglioneuroma-containing tumours of the adrenal medulla in Alderly-Park rats. Laboratory animals 1977. link 29 Mooppan MM, Banerjee AK, Bhagwat AG, Gupta NM, Katariya RN, Talwar BL. Large nonfunctioning adrenal cortical tumor: a case report. The American surgeon 1977. link

    Original source

    1. [1]
      Laparoscopic Versus Robotic Adrenalectomy: A Randomized Clinical Trial. — Berber E, Ibrahimli A, Memisoglu E, Akgun E, Perez-Soto R Annals of surgical oncology (2026)
    2. [2]
      How ready are endocrine scientists to share retrospective clinical data for research: a perspective from the European Network for the Study of Adrenal Tumors. — Sojat AS, Rance B, Neuraz A, Fassnacht M, Beuschlein F, Robledo M et al. European journal of endocrinology (2025)
    3. [3]
      The Diagnostic Value of 18F-FDG PET/CT Scan in Characterizing Adrenal Tumors. — Schaafsma M, Berends AMA, Links TP, Brouwers AH, Kerstens MN The Journal of clinical endocrinology and metabolism (2023)
    4. [4]
      Primary adrenal anastomosing haemangioma. — Zuo ZB, Zhang Q, Wu WX, Li X, Zhang L, Wang JY et al. Endokrynologia Polska (2023)
    5. [5]
      Binary Particle Swarm Optimization Intelligent Feature Optimization Algorithm-Based Magnetic Resonance Image in the Diagnosis of Adrenal Tumor. — Xu J, Tian F, Wang L, Miao Z Contrast media & molecular imaging (2022)
    6. [6]
      Non-secreting adrenal myelolipoma in a middle-aged male patient manifesting with sudden onset of severe lower back pain. — Introini C, Campodonico F, Ennas M, Di Domenico A, Foppiani L Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica (2020)
    7. [7]
      Laparoscopic posterior retroperitoneal adrenalectomy. — Taskin HE, Siperstein A, Mercan S, Berber E Journal of surgical oncology (2012)
    8. [8]
      Leiomyoma of the adrenal gland presenting as an incidentaloma. — Monsefi N, Dehghani M, Nowshadi PA, Mirkharrazi SM, Karimi A, Dabiri S Archives of Iranian medicine (2011)
    9. [9]
      The learning curve in laparoscopic adrenalectomy. — Guerrieri M, Campagnacci R, De Sanctis A, Baldarelli M, Coletta M, Perretta S Journal of endocrinological investigation (2008)
    10. [10]
      Adrenal schwannoma: a case report and review of literature. — Garg S, Mathew M, Goel T Indian journal of pathology & microbiology (2007)
    11. [11]
      Helical CT and dynamic Mr features of an adrenal ganglioneuroma. — Van Dyck P, Op de Beeck B, Parizel PM JBR-BTR : organe de la Societe royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR) (2006)
    12. [12]
      Giant adrenal myelolipoma. — Répássy DL, Csata S, Sterlik G, Iványi A Pathology oncology research : POR (2001)
    13. [13]
      Adrenocortical oncocytoma: two case reports and review of literature. — Waters PR, Haselhuhn GD, Gunning WT, Phillips ER, Selman SH Urology (1997)
    14. [14]
      Adrenal myelolipoma with abdominal pain. — Kobayashi T, Kubota Y, Sasagawa I, Suzuki H, Sanjoh Y, Yaguchi H et al. Urologia internationalis (1997)
    15. [15]
      Symptomatic leiomyoma of the adrenal. — Goldman RL, Brodey PA International urology and nephrology (1993)
    16. [16]
      Cystic adrenal mass: pseudocyst associated with hemangioma. — Kato T, Nakada T, Sasagawa I, Yaguchi H, Suzuki H, Yamaguchi T Urologia internationalis (1993)
    17. [17]
      Cavernous hemangioma of the adrenal gland. — Salup R, Finegold R, Borochovitz D, Boehnke M, Posner M The Journal of urology (1992)
    18. [18]
      Adrenal carcinosarcoma. — Decorato JW, Gruber H, Petti M, Levowitz BS Journal of surgical oncology (1990)
    19. [19]
      Mobilization of the right lobe of the liver for right adrenalectomy. — Prinz RA American journal of surgery (1990)
    20. [20]
      Adrenal myelolipoma simulating virilizing adrenal tumor. — Moskovitz B, Bolkier M, Katz Y, Ben Arieh Y, Richter Levin D Urologia internationalis (1989)
    21. [21]
      Virilization of a female infant due to an adrenal tumor. — Pardo JM Clinical pediatrics (1986)
    22. [22]
      Adrenal hemangioma: a case report. — Auh YH, Anand J, Zirinsky K, Kazam E The Journal of computed tomography (1986)
    23. [23]
      Myelolipoma of the adrenal gland. — Hanafy HM European urology (1981)
    24. [24]
      Primary nonfunctioning adrenal tumors in adults. — Athani VS, Mulholland SG Urology (1981)
    25. [25]
      Myelolipoma of adrenal. — Snearly RG, Ram MD Urology (1978)
    26. [26]
      Adrenal cortical tumors in children. — Zaitoon MM, Mackie GG Urology (1978)
    27. [27]
      Adrenal hemangiomas: angiographic appearance of a rare tumor. — Rothberg M, Bastidas J, Mattey WE, Bernas E Radiology (1978)
    28. [28]
      Ganglioneuroma-containing tumours of the adrenal medulla in Alderly-Park rats. — Glaister JR, Samuels DM, Tucker MJ Laboratory animals (1977)
    29. [29]
      Large nonfunctioning adrenal cortical tumor: a case report. — Mooppan MM, Banerjee AK, Bhagwat AG, Gupta NM, Katariya RN, Talwar BL The American surgeon (1977)
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