Androstenedione aromatization as a cause of gynecomastia in 11beta-hydroxylase and 21-hydroxylase deficiencies.
To report two cases of gynecomastia that occurred in boys with 11beta-hydroxylase and 21-hydroxylase deficiency. We describe the physical findings and summarize the laboratory evaluation and treatment of two cases encountered in our medical practice. 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. Peripheral conversion of adrenal androgen to estrogen likely caused the feminizing syndrome in these patients.