Diagnosis and Radiological Tests
The first step in the evaluation of a patient with a sex-hormone producing tumor is to have a complete history and physical examination by a physician to evaluate for the signs and symptoms. In terms of blood tests, high levels of testosterone and urinary 17-ketosteroids are suggestive of an androgen producing tumor. Elevation of DHEA-S is more indicative of an adrenal androgen-producing tumor. Elevated estrogens and urinary 17-ketosteroids are often seen in patients with feminizing tumors.
Once the diagnosis is made, CAT scan or MRI of the abdomen should be used to localize adrenal pathology and determine if there are ovarian tumors that may be the cause of the sex hormoneHormone - a chemical made by a gland that travels in the bloodstream and "tells organs what to do." overproduction. Selective venous catheterization of the adrenal and ovarian veins (blood samples drawn with catheters from both organs for testing) may be considered for tumors with uncertain localization. This is the same procedure as adrenal vein sampling for aldosteroneAldosterone - a mineralocorticoid that controls blood pressure producing tumors, but instead of measuring aldosterone, sex hormone levels are measured and levels are also measured from the veins running from the ovaries. (See Primary Hyperaldosteronism → Is this unilateral or bilateral disease → Adrenal Venous Sampling)