An occasional adrenocortical tumor secretes excessive quantities of androgens that cause intense masculiniz-ing effects throughout the body. If this occurs in a female, she develops virile characteristics, including growth of a beard, a much deeper voice, occasionally baldness if she also has the genetic trait for baldness, masculine distribution of hair on the body and the pubis, growth of the clitoris to resemble a penis, and deposi-tion of proteins in the skin and especially in the muscles to give typical masculine characteristics.
In the prepubertal male, a virilizing adrenal tumor causes the same characteristics as in the female plus rapid development of the male sexual organs, as shown in Figure 77–9, which depicts a 4-year-old boy with adrenogenital syndrome. In the adult male, the viriliz-ing characteristics of adrenogenital syndrome are usually obscured by the normal virilizing characteristics of the testosterone secreted by the testes. It is often dif-ficult to make a diagnosis of adrenogenital syndrome in the adult male. In adrenogenital syndrome, the excre-tion of 17-ketosteroids (which are derived from andro-gens) in the urine may be 10 to 15 times normal. This finding can be used in diagnosing the disease.
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