Does an androgen-secreting tumor cause hirsutism?

From the Guidelines

Androgen-secreting tumors can indeed cause hirsutism in women, as evidenced by the symptoms induced by these tumors, including hirsutism, deepening of the voice, and oligo/amenorrhea. Hirsutism is characterized by the excessive growth of dark, coarse hair in a male-like pattern, such as on the face, chest, and back. According to the study on neuroendocrine tumors 1, androgen-secreting tumors in women may induce hirsutism, among other symptoms. These tumors produce excessive amounts of androgens, like testosterone, which stimulate hair follicles to produce thicker, darker terminal hairs in areas that are typically androgen-sensitive. Some key points to consider include:

• The hirsutism caused by androgen-secreting tumors often develops rapidly and may be accompanied by other virilizing symptoms such as deepening voice, increased muscle mass, male-pattern baldness, and menstrual irregularities.
• Treatment involves surgical removal of the tumor, which can lead to resolution of hirsutism, though existing hair may require additional cosmetic treatments like laser hair removal.
• It's essential to note that androgen-secreting tumors are relatively rare causes of hirsutism, with polycystic ovary syndrome (PCOS) being much more common, but they should be considered in cases of sudden-onset, severe hirsutism, especially when accompanied by significant virilization, as reported in the study 1.

From the Research

Causes of Hirsutism

• Hirsutism is excess terminal hair that commonly appears in a male pattern in women 2
• The most common cause of hirsutism is polycystic ovary syndrome, accounting for three out of every four cases 2
• Other causes of hirsutism include:
  • Idiopathic hyperandrogenemia
  • Adrenal hyperplasia due to 21-hydroxylase deficiency
  • Androgen-secreting tumors
  • Iatrogenic hirsutism
  • Acromegaly
  • Cushing syndrome
  • Hyperprolactinemia
  • Hypo- or hyperthyroidism 3, 4, 5

Androgen-Secreting Tumors and Hirsutism

• Androgen-secreting tumors can cause hirsutism 2, 3, 4, 5
• Symptoms and findings suggestive of neoplasm include rapid onset of symptoms, signs of virilization, and a palpable abdominal or pelvic mass 2
• A total testosterone level greater than 200 ng per dL (6.94 nmol per L) should prompt evaluation for an androgen-secreting tumor 2
• Surgical excision may be needed for pituitary, adrenal, or ovarian adenomas 4

Diagnosis and Treatment of Hirsutism

• Diagnostic guidelines are predominantly aimed at premenopausal women but an appropriate evaluation for underlying endocrinopathies in postmenopausal women and men may be required 4
• Management is aimed at eliminating drugs that cause hirsutism when possible, evaluation of underlying hypothalamic-pituitary-gonadal axis dysregulation, and detection of androgen-secreting tumors 4
• Pharmacotherapy options include combination estrogens-progestins, antiandrogens, 5-alpha reductase inhibitors, biguanides, gonadotropin-releasing hormone agonists, and topical ornithine decarboxylase inhibitors 4, 6