{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T10:37:35Z","timestamp":1769078255220,"version":"3.49.0"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,6,6]]},"abstract":"<jats:p>A 26-year-old woman with a history of polycystic ovarian syndrome presented with secondary amenorrhea, worsening hirsutism, acne, deepening of voice and unexplained 10\u201320\u2009kg weight gain. Her Ferriman-Gallway hirsutism score was 12 with cystic facial acne and increased masculine phenotype. Urine Beta-Human Chorionic Gonadotropins (bHCG) was negative. She had elevated serum testosterone of 551\u2009ng\/dL, androstenedione at 7.46\u2009ng\/mL and dehydroepiandrosterone sulfate (DHEAS) at 4243\u2009\u00b5g\/L. Overnight dexamethasone suppression test showed mildly unsuppressed cortisol (2.89 \u00b5g\/dL). Urinary free cortisol along with paired serum cortisol and adrenocorticotrophic hormone (ACTH) tests were normal (55.4 \u00b5g\/24\u2009hours, 13.44 mcg\/dL, 30.4\u2009pg\/mL respectively). Her leutinizing hormone (LH) was low(&lt;0.1 mIU\/mL), follicle stimulating hormone (FSH) low\/normal (1.41 mIU\/mL) with sex hormone binding globulin (SHBG) level 45nmol\/L and the rest of the pituitary and adrenal workup was unremarkable. Thyroid stimulating hormone (TSH) was 2.15mU\/mL. MRI revealed a 3.1\u2009cm, indeterminate but well-defined left adrenal lesion and polycystic ovaries without abdominal lymphadenopathy. Given radiological appearances and despite biochemical concerns for adrenocortical malignancy, a multidisciplinary team meeting decision was made to proceed with laparoscopic adrenalectomy. Histology was consistent with a benign adenoma. Postoperatively, there was clinical and biochemical resolution of the disease.<\/jats:p>","DOI":"10.1136\/bcr-2018-224804","type":"journal-article","created":{"date-parts":[[2018,7,30]],"date-time":"2018-07-30T13:16:08Z","timestamp":1532956568000},"page":"bcr-2018-224804","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Florid hyperandrogenism due to a benign adrenocortical adenoma"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4748-2700","authenticated-orcid":false,"given":"Melanie","family":"LaVoie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasilis","family":"Constantinides","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noel","family":"Robin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelos","family":"Kyriacou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,30]]},"reference":[{"key":"2025042705440505000_2018.jul27_1.bcr-2018-224804.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199410133311502"},{"key":"2025042705440505000_2018.jul27_1.bcr-2018-224804.2","unstructured":"John H , Mattox SP . 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