case_images: PMC10075358_01
case_images: (A) CT image of bilateral adrenal tumors. (B) CT image of the left adrenal tumor after right adrenal tumorectomy. (C) Surgical specimen of the left adrenal tumor. (D) Haematoxylin and eosin staining of the left adrenal tumor (magnificationx20).
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case_images: The patient's bilateral adrenal tumors were gradually enlarged ( Figure 1A ) and were considered to be responsible for hyperandrogenism. Because the patient's amenorrhea was not relieved, she was admitted to our hospital and underwent further endocrine and imageological examination ( Figure 1B ). The patient underwent left laparoscopic adrenalectomy in our hospital, and the surgical specimen was showed in  Figure 1C . The histopathologic examination confirmed the diagnosis of adrenocortical adenoma ( Figure 1D ).
case_images: Exclusively increased steroid hormones in the androgen-producing pathway in the patient. DHEA, dehydroepiandrosterone; DS, dehydroepiandrosterone sulfate.
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case_images: Adrenal steroid hormone tests indicated that pregnenolone and dehydroepiandrosterone (DHEA) were also elevated in addition to T, DS, AND and 17OHP, while the levels of steroids located in the cortisol and aldosterone synthesis pathways were normal ( Figure 2 ).
case_images: Bilateral ovarian venous sampling (OVS) and left adrenal venous sampling (AVS).
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case_images: Bilateral ovarian venous sampling (OVS) and left adrenal venous sampling (AVS) were conducted ( Figure 3 ). T, ADN, DS and DHEA, in the left adrenal vein were higher ( Figure 3 ), which indicated that excessive androgens were produced by the left adrenal gland rather than the ovaries.