Adrenal oncocytoma: an unusual etiology of Cushing’s syndrome in an adolescent female

Saba Samad Memon; Manjunath Havalappa Dodamani; Sanjay Chaudhari; Zalak Parmar; Kaushal Patel; Suresh Bhoi; Ravikumar Shah

doi:10.1515/jpem-2025-0369

Article

Adrenal oncocytoma: an unusual etiology of Cushing’s syndrome in an adolescent female

Saba Samad Memon , Manjunath Havalappa Dodamani , Sanjay Chaudhari , Zalak Parmar , Kaushal Patel , Suresh Bhoi and Ravikumar Shah

Published/Copyright: October 1, 2025

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 39 Issue 1

Abstract

Objectives

This report presents a rare pediatric functional AO causing CS and androgen excess. It aims to discuss the diagnostic challenges of cortisol and DHEAS co-secretion, which may mimic adenomas or carcinomas. It also emphasizes the role of clinical, biochemical, and imaging assessments, as well as histological classification using LWB criteria, and the need for long-term follow-up.

Case presentation

A 17-year-old female presented with weight gain, moon facies, cushingoid striae, oligomenorrhea, and acne over six months. Examination showed hypertension, grade I obesity, cushingoid stigmata without virilization. Endocrine evaluation was confirmed ACTH independent CS due to right AO.

Conclusions

This case illustrates functional AO as a rare cause of adolescent CS with androgen excess. Co-secretion patterns complicate diagnosis, imaging may not be definitive, and long-term follow-up is vital due to uncertain prognosis.

Keywords: adrenal oncocytoma; Cushing’s syndrome; hormone Co-secretion; cortisol and DHEAS; Lin-Weiss-Bisceglia criteria

Corresponding author: Dr. Ravikumar Shah, Department of Endocrinology, Currently Consultant Endocrinologist, Harikrushna Hormone Clinic, Anand, Gujarat, 388001, India; and Harikrushna Hormone Clinic, Anand, Gujarat, India, E-mail: rk_shreeji@yahoo.com

Acknowledgments

Ms. Palak Raj-helped in retrieving the case details and prepare the manuscript.

Research ethics: Not applicable.
Informed consent: Informed consent was obtained from their legal guardians.
Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Use of Large Language Models, AI and Machine Learning Tools: Not applicable.
Conflict of interest: The authors state no conflict of interest.
Research funding: None declared.
Data availability: Not applicable.

References

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Received: 2025-06-30

Accepted: 2025-09-05

Published Online: 2025-10-01

Published in Print: 2026-01-23

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https://doi.org/10.1515/jpem-2025-0369

Keywords for this article

adrenal oncocytoma; Cushing’s syndrome; hormone Co-secretion; cortisol and DHEAS; Lin-Weiss-Bisceglia criteria