Endocrine Abstracts

Functioning adrenal masses are often a diagnostic challenge and can present with unusual symptoms. We describe a case of a 37-year-old male with a background of ulcerative colitis, who presented with gynecomastia in the breast clinic. His serumbiochemistry showed persistently elevated Oestradiol and prolactin, with low testosterone and FSH. On physical examination, he had marked breast tenderness, bilateral gynecomastia and no signs of steroid excess. He reported a decline in his libido but no erectile dysfunction. After excluding common causes of gynecomastia, further investigations were performed to investigate the cause of raised Oestradiol. Differential diagnoses considered included exogenous source, testicular tumours, feminising adrenal tumours (FATs), or aromatase excess syndrome. Subsequently, CTadrenal showed a well-defined enhancing tumour, arising from the left adrenal gland measuring 5cm in the maximum axial dimension. The PET FDG confirmed a hypermetabolic tumour on the left adrenal with no distant metastases. The patient underwent urgent laparoscopic surgery with an excellent surgical and biochemical outcome.