title: Virilizing adrenal cortical carcinoma.
abstract: A 43-year-old man with a 36-year history of virilization due to an adrenal carcinoma is presented. The initial presentation at age 7 with precocious puberty and epiphyseal bone fusion suggested increased androgen effect at a very early age. The patient's 36-year course before his death suggested either a very slow growing adrenal carcinoma or untreated congenital adrenal hyperplasia that progressed to an adrenal carcinoma. Endocrine evaluation showed markedly increased DHEA and DHEA-sulfate levels. These were associated with elevated plasma and urinary estradiol levels and suppressed LH and FSH plasma concentrations. The 24-hour mean levels of cortisol and testosterone were normal. Studies of the circadian periodicity of cortisol showed a disturbed temporal pattern but a normal 24-hour mean concentration that correlated with a normal cortisol production rate. The 24-hour LH secretory pattern showed a decrease in the normal episodic fluctuation of this hormone over the 24-hour period.
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications* / Q000378:metabolism; D000310:Adrenal Gland Neoplasms / Q000150:complications*; D000328:Adult; D002277:Carcinoma / Q000150:complications* / Q000378:metabolism; D002940:Circadian Rhythm; D003687:Dehydroepiandrosterone / Q000378:metabolism; D004958:Estradiol / Q000378:metabolism; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007986:Luteinizing Hormone / Q000378:metabolism; D008297:Male; D013739:Testosterone / Q000378:metabolism; D013997:Time Factors; D014770:Virilism / Q000209:etiology* / Q000378:metabolism
chemical_list: D013739:Testosterone; D003687:Dehydroepiandrosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone