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. 1994 Aug;70(826):584–588. doi: 10.1136/pgmj.70.826.584

Dexamethasone-suppressible feminizing adrenal adenoma.

M Paja 1, S Díez 1, T Lucas 1, A Ojeda 1, L Salto 1, J Estrada 1
PMCID: PMC2397683  PMID: 7937454

Abstract

A 39 year old man presented with gynaecomastia, loss of libido and high blood pressure. Hormone studies revealed elevated plasma levels of oestradiol and its precursors, which increased in response to adrenocorticotrophic hormone and were reduced to normal levels with dexamethasone. Computed tomography disclosed a left adrenal mass and surgery was performed. The removed tumour weighed 84 g and the histological diagnosis was of adenoma. Nine years after surgery, he is asymptomatic, without hypertension, and radiological and or hormonal evidence of recurrence. We discuss the hormone profile in this case and the dynamics of steroid production by the tumour which, in contrast to the classical concept of tumour autonomy, showed dependence of oestradiol secretion on endogenous adrenocorticotrophic hormone.

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Selected References

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  1. Aupetit-Faisant B., Battaglia C., Zenatti M., Emeric-Blanchouin N., Legrand J. C. Hypoaldosteronism accompanied by normal or elevated mineralocorticosteroid pathway steroid: a marker of adrenal carcinoma. J Clin Endocrinol Metab. 1993 Jan;76(1):38–43. doi: 10.1210/jcem.76.1.8421100. [DOI] [PubMed] [Google Scholar]
  2. Bacon G. E., Lowrey G. H. Feminizing adrenal tumor in a six-year-old boy. J Clin Endocrinol Metab. 1965 Oct;25(10):1403–1406. doi: 10.1210/jcem-25-10-1403. [DOI] [PubMed] [Google Scholar]
  3. Barcelo B., Abascal J., Ardaiz J., Gil P., Colas A., Menendez J., Inchausti J. L. Feminizing adrenocortical carcinoma in a postmenopausal woman. Postgrad Med J. 1979 Jun;55(644):406–408. doi: 10.1136/pgmj.55.644.406. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bertagna C., Orth D. N. Clinical and laboratory findings and results of therapy in 58 patients with adrenocortical tumors admitted to a single medical center (1951 to 1978). Am J Med. 1981 Nov;71(5):855–875. doi: 10.1016/0002-9343(81)90384-3. [DOI] [PubMed] [Google Scholar]
  5. Bhettay E., Bonnici F. Pure oestrogen-secreting feminizing adrenocortical adenoma. Arch Dis Child. 1977 Mar;52(3):241–243. doi: 10.1136/adc.52.3.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cathelineau G., Poizat R. Tumeur féminisante de la surrénale avec hyperaldostéronisme primaire et hypertension artérielle maligne. Evolution terminale. Ann Endocrinol (Paris) 1976 Jan-Feb;37(1):59–60. [PubMed] [Google Scholar]
  7. Comite F., Schiebinger R. J., Albertson B. D., Cassorla F. G., Vander Ven K., Cullen T. F., Loriaux D. L., Cutler G. B., Jr Isosexual precocious pseudopuberty secondary to a feminizing adrenal tumor. J Clin Endocrinol Metab. 1984 Mar;58(3):435–440. doi: 10.1210/jcem-58-3-435. [DOI] [PubMed] [Google Scholar]
  8. Desai M. B., Kapadia S. N. Feminizing adrenocortical tumors in male patients: adenoma versus carcinoma. J Urol. 1988 Jan;139(1):101–103. doi: 10.1016/s0022-5347(17)42307-x. [DOI] [PubMed] [Google Scholar]
  9. Freeman D. A. Steroid hormone-producing tumors in man. Endocr Rev. 1986 May;7(2):204–220. doi: 10.1210/edrv-7-2-204. [DOI] [PubMed] [Google Scholar]
  10. Freeman D. A. Steroid hormone-producing tumors of the adrenal, ovary, and testes. Endocrinol Metab Clin North Am. 1991 Dec;20(4):751–766. [PubMed] [Google Scholar]
  11. GABRILOVE J. L., SHARMA D. C., WOTIZ H. H., DORFMAN R. I. FEMINIZING ADRENOCORTICAL TUMORS IN THE MALE. A REVIEW OF 52 CASES INCLUDING A CASE REPORT. Medicine (Baltimore) 1965 Jan;44:37–79. doi: 10.1097/00005792-196501000-00002. [DOI] [PubMed] [Google Scholar]
  12. Gabrilove J. L., Nicolis G. L., Hausknecht R. U., Wotiz H. H. Feminizing adrenocortical carcinoma in a man. Cancer. 1970 Jan;25(1):153–160. doi: 10.1002/1097-0142(197001)25:1<153::aid-cncr2820250122>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  13. Gabrilove J. L., Nicolis G. L., Sohval A. R. Non-tumorous feminizing adrenogenital syndrome in the male subject. J Urol. 1973 Dec;110(6):710–713. doi: 10.1016/s0022-5347(17)60321-5. [DOI] [PubMed] [Google Scholar]
  14. Gröndal S., Eriksson B., Hagenäs L., Werner S., Curstedt T. Steroid profile in urine: a useful tool in the diagnosis and follow up of adrenocortical carcinoma. Acta Endocrinol (Copenh) 1990 May;122(5):656–663. doi: 10.1530/acta.0.1220656. [DOI] [PubMed] [Google Scholar]
  15. Howard C. P., Takahashi H., Hayles A. B. Feminizing adrenal adenoma in a boy. Case report and literature review. Mayo Clin Proc. 1977 Jun;52(6):354–357. [PubMed] [Google Scholar]
  16. Hsueh A. J., Erickson G. F. Glucocorticoid inhibition of FSH-induced estrogen production in cultured rat granulosa cells. Steroids. 1978 Dec;32(5):639–648. doi: 10.1016/0039-128x(78)90074-0. [DOI] [PubMed] [Google Scholar]
  17. Hussain S., Belldegrun A., Seltzer S. E., Richie J. P., Gittes R. F., Abrams H. L. Differentiation of malignant from benign adrenal masses: predictive indices on computed tomography. AJR Am J Roentgenol. 1985 Jan;144(1):61–65. doi: 10.2214/ajr.144.1.61. [DOI] [PubMed] [Google Scholar]
  18. Itami R. M., Amundson G. M., Kaplan S. A., Lippe B. M. Prepubertal gynecomastia caused by an adrenal tumor. Diagnostic value of ultrasonography. Am J Dis Child. 1982 Jul;136(7):584–586. doi: 10.1001/archpedi.1982.03970430016004. [DOI] [PubMed] [Google Scholar]
  19. King D. R., Lack E. E. Adrenal cortical carcinoma: a clinical and pathologic study of 49 cases. Cancer. 1979 Jul;44(1):239–244. doi: 10.1002/1097-0142(197907)44:1<239::aid-cncr2820440139>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  20. Klein F. A., Miller N. L., Hackler R. H. Flow cytometry in feminizing adrenocortical carcinoma. J Urol. 1985 Nov;134(5):933–935. doi: 10.1016/s0022-5347(17)47533-1. [DOI] [PubMed] [Google Scholar]
  21. LIPSETT M. B., HERTZ R., ROSS G. T. CLINICAL AND PATHOPHYSIOLOGIC ASPECTS OF ADRENOCORTICAL CARCINOMA. Am J Med. 1963 Sep;35:374–383. doi: 10.1016/0002-9343(63)90179-7. [DOI] [PubMed] [Google Scholar]
  22. McAreavey D., Cumming A. M., Boddy K., Brown J. J., Fraser R., Leckie B. J., Lever A. F., Morton J. J., Robertson J. I., Williams E. D. The renin-angiotensin system and total body sodium and potassium in hypertensive women taking oestrogen-progestagen oral contraceptives. Clin Endocrinol (Oxf) 1983 Feb;18(2):111–118. doi: 10.1111/j.1365-2265.1983.tb03192.x. [DOI] [PubMed] [Google Scholar]
  23. McKenna T. J., O'Connell Y., Cunningham S., McCabe M., Culliton M. Steroidogenesis in an estrogen-producing adrenal tumor in a young woman: comparison with steroid profiles associated with cortisol- and androgen-producing tumors. J Clin Endocrinol Metab. 1990 Jan;70(1):28–34. doi: 10.1210/jcem-70-1-28. [DOI] [PubMed] [Google Scholar]
  24. Mersey J. H., Ceballos L., Levin P., Busky S. Estrogen-secreting adrenal tumor responsive to ACTH: localization by adrenal venous sampling. South Med J. 1988 Feb;81(2):275–278. doi: 10.1097/00007611-198802000-00034. [DOI] [PubMed] [Google Scholar]
  25. Minowada S., Kinoshita K., Hara M., Isurugi K., Uchikawa T., Niijima T. Measurement of urinary steroid profile in patients with adrenal tumor as a screening method for carcinoma. Endocrinol Jpn. 1985 Feb;32(1):29–37. doi: 10.1507/endocrj1954.32.29. [DOI] [PubMed] [Google Scholar]
  26. Saez J. M., Dazord A., Gallet D. ACTH and prostaglandin receptors in human adrenocortical tumors. Apparent modification of a specific component of the ACTH-binding site. J Clin Invest. 1975 Sep;56(3):536–547. doi: 10.1172/JCI108122. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Schteingart D. E., Oberman H. A., Friedman B. A., Conn J. W. Adrenal cortical neoplasms producing cushing's syndrome. A clinicopathologic study. Cancer. 1968 Nov;22(5):1005–1013. doi: 10.1002/1097-0142(196811)22:5<1005::aid-cncr2820220516>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  28. Solomon S. S., Swersie S. P., Paulsen C. A., Biglieri E. G. Feminizing adrenocortical carcinoma with hypertension. J Clin Endocrinol Metab. 1968 May;28(5):608–612. doi: 10.1210/jcem-28-5-608. [DOI] [PubMed] [Google Scholar]
  29. Valensi P., Coussieu C., Kemeny J. L., Attali J. R., Amouroux J., Sebaoun J. Endocrine investigations in two cases of feminizing Leydig cell tumour. Acta Endocrinol (Copenh) 1987 Jul;115(3):365–372. doi: 10.1530/acta.0.1150365. [DOI] [PubMed] [Google Scholar]
  30. Veldhuis J. D., Sowers J. R., Rogol A. D., Klein F. A., Miller N., Dufau M. L. Pathophysiology of male hypogonadism associated with endogenous hyperestrogenism. Evidence for dual defects in the gonadal axis. N Engl J Med. 1985 May 23;312(21):1371–1375. doi: 10.1056/NEJM198505233122107. [DOI] [PubMed] [Google Scholar]

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