July - September 2014, Volume 10, Issue 3

Matulevicius V, Ostrauskas R, Krasauskas V, Verkauskiene R, Ciaplinskiene L, , Urbanavicius V

Adrenal Androgen Producing Adenoma Associated with Epileptic Seizures

Acta Endo (Buc) 2014, 10 (3): 487-494
doi: 10.4183/aeb.2014.487

Background. Dehydroepiandrosterone sulphate (DHEA-S) is a major steroid product of adrenal glands and an important neurosteroid, but due to only slight androgenic activities pathology of DHEA-S secretion it was rarely described until now. Aim. To report a case of DHEA-S and testosterone secreting adrenal tumour with clinical manifestations of suddenly appeared epileptic seizures, amenorrhea, hirsutism, weight gain and decreased sexual activity before operation, and up to 12 months observation after surgical removal of the tumour. Methods. Presentation of clinical case with comments. Results. Epileptic seizures, amenorrhea, weight gain and hirsutism suddenly appeared in a 38-year-old fertile woman. A right adrenal tumour was detected. Blood levels of DHEA-S and testosterone were very high. Surgical removal of the adenoma (confirmed histologically) was performed what conditioned decrease of DHEA-S, testosterone and other hormones in 2-24 hours for the level of adrenal insufficiency. After a month all the hormones returned to normal level and were maintained at this level for 12 months after operation, excepting aldosterone, which increased gradually. Menses reappeared in six weeks after a short period of hot flashes and perspirations. Seizures did not appear in 12 months. Sexual activity was lowered one month before and after the operation, and it was maximal 6-12 months after operation. Conclusions. We report a case with complete recovery of a 38-year-old woman, presented with epileptic seizures, amenorrhea, hirsutism, weight gain and decrease of sexual activity, before and after surgical removal of DHEA-S and testosterone secreting adrenal tumour.

Keywords: Dehydroepiandrosterone sulphate, testosterone, adrenocortical oncocytoma, seizures, sexuality.

Correspondence: Valentinas Matulevicius MD, PhD, Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50009, Kaunas, Lithuania, E-mail: valentinasmatulevicius@ymail.com