Endocrine Abstracts

Recently we described clinical case of 38-year-old fertile woman with sudden onset of a multiple clinical symptoms: weight gain, secondary amenorrhea, hirsutism and seizures. Adrenal tumour co-secreted high amounts of DHEA sulfate, testosterone (T) and aldosterone (A) (Matulevicius et al. 2014). The symptoms of the disease disappeared after laparoscopic removal of adrenal tumour, which proved to be an adrenocortical oncocytoma. A hypersecretion of A remained after resection of adrenal tumour, suggesting subclinical hyperandrosteronism. In attempt to find more such cases, we analysed results of DHEAS determinations in two university hospitals of Lithuania (Vilnius and Kaunas) during 1 year – 2014. We checked 1215 DHEAS results of 18–50-year-old woman to investigate our hypothesis. Increased DHEAS was considered when patient’s DHEAS concentration was higher than maximal value of DHEAS indicated in the assay kit (11.76%) and was found in 143 cases. Mild increase was in 87.4%, moderate increase – in 9.8% and high increased – in 2.8%. These results confirm that mild increase of DHEAS is frequent (DHEASism). High increase of DHEAS is very rare – found only in four patients (DHEASoma). From these DHEASoma is confirmed in one patient and three are under investigation. Analysing the publications of the last 10-years about increased DHEAS concentration we found that increased DHEAS concentration is frequent in 18–50-year-old woman. These findings are linked to the polycystic ovary syndrome. In this syndrome DHEAS is increased in 20–30%. Elevated DHEAS was found in 9/11 adrenal cancers. Apart of our case, we found two more DHEASoma benign tumor cases in literature. Rarity of DHEASoma suggests that multicentral and multidisciplinary efforts are necessary for discovering and defining the disease.