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[Virilizing and feminizing adrenal syndrome]
1Department of Urology, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029.
Objective:
To inquire into diagnosis, differential diagnosis and treatment of virilizing and feminizing adrenal syndrome especially differential diagnosis between benign and malignant of sex hormone producing adrenal neoplasma and treatment principles of congenital adrenal hyperplasia (CAH).
Method:
Eight cases of CAH and five cases of sex hormone producing adrenal neoplasma were presented during 1986-1996. The former included 3 rare cases of 17 alpha hydroxylase deficiency and others. The latter included 3 cases of feminizing adrenal tumors and 2 cases of virilizing adrenal tumors.
Result:
Weight and diameter of tumor, DHEA, 17-ks and sex hormone levels, appearance of CT imaging, infiltration and metastasis, were closely related to differentiation of benign and malignant tumors.
Conclusion:
Some standards are not absolute because of limited practice, follow-up is very important. Adrenal virilizing and feminizing neoplasms were surgically resected by different incision. Modified subcostal incision is recommended as a best choice for huge adrenal mass. Corticoadrenal hormone treatment of CAH should select different kind of corticoadrenal medicine for different kind of CAH. Treatment of sex hormones is not suitable for children suffered from 17 hydroxylase deficiency until prepuberty.