Hyperandrogenism-induced Athletic Excellence in a Young Patient with Adrenocortical Carcinoma: 10 Years of Remission

A 17-year-old female softball player presented with progressive virilization and markedly enhanced athletic performance. Laboratory evaluation revealed elevated serum testosterone with autonomous adrenal secretion. Imaging analysis demonstrated an 8-cm right adrenal mass. Adrenalectomy was performed, and histopathological examination confirmed stage II adrenocortical carcinoma (ACC) with a Ki-67 labeling index of 14%. Postoperatively, she received adjuvant mitotane therapy. At 34 months, a solitary hepatic metastasis was successfully treated with radiofrequency ablation and combination chemotherapy. She has remained disease-free for more than 8 years following initial surgery. This case demonstrates the clinical impact of pathological hyperandrogenism on athletic performance and highlights the potential for long-term remission in young patients with aggressive ACC managed through multimodal therapy.