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Departments of Internal Medicine,
1 Surgery, and
2 Nuclear Medicine Division, University of Messina School of Medicine, Policlinico Universitario, Messina, Italy
3 Section of Endocrinology, Clinical-Experimental Department of Medicine and Pharmacology, Program of Clinical and Molecular Endocrinology, Azienda Ospedaliera Gaetano MartinoMessina, University of Messina School of Medicine, Policlinico Universitario, Messina, Italy
(Requests for offprints should be addressed to A Lasco, Via Faustina e Tertullo, 19 98100 Messina, Italy; Email: alasco{at}unime.it)
A 57-year-old woman presented with an apparently obvious diagnosis of iatrogenic virilization. At the age of 51, she began a 4-year treatment with prednisone or cyclosporine, which are known to promote hair growth, for Behçet disease. At the age of 56, osteoporosis was overtreated with the anabolic steroid nandrolone. Insignificant inhibition by dexamethasone of the extremely high serum concentrations of testosterone and less high concentrations of weak androgens prompted us to search for a virilizing tumor. Computed tomography showed a 2.3 x 1.5 cm nodule in the right adrenal gland. As the patient refused surgery, virilization was treated with the antiandrogen cyproterone acetate (CPA), but for only 4 months because clinical and hormone abnormalities reversed and the tumor was no longer visible. The patient remains symptom-free. This first report of a curative effect of CPA on a purely virilizing adrenal tumor opens new avenues in the management of such tumors.
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