In these cases, it is essential to complete the diagnostic procedure with the measurement of tumor markers (alpha 1-fetoprotein, beta-HCG, CEA and CA125), in order to exclude hypersecretion of sex steroids of a neoplastic or paraneoplastic nature, and the measurement of serum dehydroepiandrosterone sulfate (DHEA-S) and 17-hydroxyprogesterone levels is advisable, which may be increased in adrenal tumors or congenital adrenal hyperplasia due to 21-hydroxylase deficiency [11,49]. This evidence concerns the gene AFP and classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency.