Androstenedione aromatization as a cause of gynecomastia in 11beta-hydroxylase and 21-hydroxylase deficiencies.

OBJECTIVE

To report two cases of gynecomastia that occurred in boys with 11beta-hydroxylase and 21-hydroxylase deficiency.

METHODS

We describe the physical findings and summarize the laboratory evaluation and treatment of two cases encountered in our medical practice.

RESULTS

Both of our patients (a 4-year-old boy and a 17-year-old boy) had extreme virilization and gynecomastia; on laboratory assessment, androstenedione and estrogen levels were high. Treatment with hydrocortisone was recommended.

CONCLUSION

Peripheral conversion of adrenal androgen to estrogen likely caused the feminizing syndrome in these patients.