{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:23:23Z","timestamp":1783445003342,"version":"3.54.6"},"reference-count":11,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":3333,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>In a 61-year-old Caucasian male with prostate cancer, leuprolide and bicalutamide failed to suppress the androgens. He presented to endocrinology with persistently normal testosterone and incidental massive (up to 18\u2009cm) bilateral adrenal myelolipomas on CT scan. Blood test did not reveal metanephrine excess. The patient was noted to have short stature (151\u2009cm) and primary infertility. Elementary school photographs demonstrated precocious puberty. Physical examination revealed palpable abdominal (adrenal) masses. Abiraterone and glucocorticoid treatment was commenced with excellent suppression of testosterone. Genetic testing revealed a mutation in CYP21A2 confirming 21-hydroxylase-deficient congenital adrenal hyperplasia (CAH). Association of large myelolipomas with CAH has been reported in the literature. Our case highlights the importance of considering CAH in patients with non-suppressed testosterone despite androgen deprivation therapy. Large myelolipomas should raise the suspicion of congenital adrenal hyperplasia.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Learning points:<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1530\/edm-17-0108","type":"journal-article","created":{"date-parts":[[2017,10,28]],"date-time":"2017-10-28T00:48:58Z","timestamp":1509151738000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Massive adrenal incidentalomas and late diagnosis of congenital adrenal hyperplasia in prostate cancer"],"prefix":"10.1530","volume":"2017","author":[{"given":"Xin","family":"Feng","sequence":"first","affiliation":[{"name":"Division of Endocrinology","department":["Department of Medicine, University of Calgary, Calgary, Alberta,Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Kline","sequence":"additional","affiliation":[{"name":"Division of Endocrinology","department":["Department of Medicine, University of Calgary, Calgary, Alberta,Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2017,10,28]]},"reference":[{"key":"2026070712304306800_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(17)31431-9","article-title":"Congenital adrenal hyperplasia","author":"El-Maouche","year":"2017","journal-title":"Lancet"},{"key":"2026070712304306800_bib2","doi-asserted-by":"crossref","first-page":"916891","DOI":"10.1155\/2009\/916891","article-title":"Two adults with adrenal myelolipoma and 21-hydroxylase deficiency","volume":"2009","author":"Nermoen","year":"2009","journal-title":"Case Reports in Medicine"},{"key":"2026070712304306800_bib3","doi-asserted-by":"crossref","first-page":"e217","DOI":"10.4158\/EP161343.CR","article-title":"Gender reversal and bilateral giant adrenal myelolipomas in a 46,XX patient with 21-hydroxylase deficiency: case report and review of the literature","volume":"3","author":"Westcott","year":"2017","journal-title":"AACE Clinical Case Reports"},{"key":"2026070712304306800_bib4","author":"Committee CCSA","year":"2017","journal-title":"Canadian Cancer Statistics 2017"},{"key":"2026070712304306800_bib5","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1056\/NEJMoa1704174","article-title":"Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer","volume":"377","author":"Fizazi","year":"2017","journal-title":"New England Journal of Medicine"},{"key":"2026070712304306800_bib6","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1038\/sj.bjc.6604904","article-title":"CYP17 blockade by abiraterone: further evidence for frequent continued hormone-dependence in castration-resistant prostate cancer","volume":"100","author":"Ang","year":"2009","journal-title":"British Journal of Cancer"},{"key":"2026070712304306800_bib7","doi-asserted-by":"crossref","first-page":"2611","DOI":"10.1073\/pnas.1300057110","article-title":"Genotype-phenotype correlation in 1507 families with congenital adrenal hyperplasia owing to 21-hydroxylase deficiency","volume":"110","author":"New","year":"2013","journal-title":"PNAS"},{"key":"2026070712304306800_bib8","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2013-010395","article-title":"Inadequate testosterone suppression after medical and subsequent surgical castration in a patient with prostate cancer","volume":"2013","author":"Ragnarsson","year":"2013","journal-title":"BMJ Case Reports"},{"key":"2026070712304306800_bib9","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4103\/0970-1591.152807","article-title":"Adrenal myelolipoma: controversies in its management","volume":"31","author":"Shenoy","year":"2015","journal-title":"Indian Journal of Urology"},{"key":"2026070712304306800_bib10","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1111\/j.1365-2265.2011.04151.x","article-title":"High frequency of adrenal myelolipomas and testicular adrenal rest tumours in adult Norwegian patients with classical congenital adrenal hyperplasia because of 21-hydroxylase deficiency","volume":"75","author":"Nermoen","year":"2011","journal-title":"Clinical Endocrinology"},{"key":"2026070712304306800_bib11","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1515\/JPEM.2001.14.4.415","article-title":"Adrenal nodules in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency: regression after adequate hormonal control","volume":"14","author":"Giacaglia","year":"2001","journal-title":"Journal of Pediatric Endocrinology and Metabolism"}],"container-title":["Endocrinology, Diabetes &amp; 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