GYNECOMASTIA AND RETARDED SEXUAL DEVELOPMENT RESULTING FROM A LONG-STANDING ESTROGEN-SECRETING ADRENAL TUMOR*

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Abstract
AMONG functioning adrenocortical tumors, those with activity confined largely to the secretion of pathogenic quantities of estrogens are by far the most unusual. In 1948 Wilkins (1) reviewed the data on 10 patients with “feminizing” tumors which had led to gynecomastia and a variable regression of masculine characteristics, and contributed the details in 2 more patients, one an adult studied by W. W. Scott and the other a 5-yearold boy. Four additional cases (2, 3, 4) have been reported since then. In most of these instances the tumors have been malignant and in all of them the development of the gynecomastia and other signs has been rather acute and intense. The patient to be described in this report differed from these in that he was shown to have a large benign tumor which was judged to have been present in a moderately active state for sixteen years, the oversecretion of estrogens leading to a relatively stable gynecomastia, mild hypogonadism and impaired spermatogenesis. The age at onset, the moderation of secretory activity and the chronicity of the condition made for some confusion with similar syndromes featuring gynecomastia, thus emphasizing the need for a sharpening of diagnostic criteria and a re-evaluation of the pathogenesis of gynecomastia in these other conditions.