Sexual precocity in a female infant due to feminizing adrenal carcinoma.

A 21-month-old female with virilizing and then feminizing sexual precocity due to an adrenal adenocarcinoma treated surgically at 21 months of age is reported. Urinary neutral 17-ketosteroids were 116 and 106 mg/24 h and correlated with high plasma levels (1408 microgram/dl) of dehyroepiandrosterone sulfate. Plasma estradiol (17 ng/dl) and urinary estradiol levels (6.3 and 7.1 mu/24 h) were elevated to adult levels and associated with breast development, clitoral enlargement, and an estrogenized vagina. Plasma cortisol was normal. The patient remains healthy over 10 yr later, although capsular invasion was present.