title: Adrenocortical carcinoma with Cushing's syndrome presenting unusual urinary 17-ketosteroid fractionation.
abstract: A case of adrenal carcinoma with Cushing's syndrome was presented. Endocrinological and morphological investigations disclosed the presence of a functional adrenal carcinoma. This case was characterized by its unusual urinary 17-ketosteroid (17-KS) fractionation, i.e. a marked elevation of 17-KS was accompanied by the increments of etiocholanolone, but not of dehydroepiandrosterone (DHEA) or androsterone. Measurements of the plasma adrenocorticosteroids revealed normal DHEA and DHEA-S (sulfate) levels, moderately increased 17-OH-pregnenolone, and markedly increased (less than 100 times the normal) 11-deoxycortisol (cpd S). Therefore, it seems plausible that the normal urinary DHEA level in this patient would have occurred as a result of remarkably low C17-20 lyase activity sufficient to hamper DHEA production, and that markedly increased etiocholanolone might possibly have been converted from cpd S as well as from DHEA and androstenedione through 5 beta-reduction.
authors.forename: H
authors.initials: H
authors.lastname: Watanobe
authors.forename: K
authors.initials: K
authors.lastname: Kannari
authors.forename: K
authors.initials: K
authors.lastname: Kimura
authors.forename: K
authors.initials: K
authors.lastname: Takebe
mesh_terms: D015068:17-Ketosteroids / Q000652:urine*; D006907:17-alpha-Hydroxypregnenolone / Q000097:blood; D000306:Adrenal Cortex Neoplasms / Q000150:complications* / Q000652:urine; D000328:Adult; D000735:Androstenedione / Q000652:urine; D000738:Androsterone / Q000652:urine; D003350:Cortodoxone / Q000097:blood; D003480:Cushing Syndrome / Q000150:complications* / Q000652:urine; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood / Q000652:urine; D019314:Dehydroepiandrosterone Sulfate; D005043:Etiocholanolone / Q000652:urine; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D015068:17-Ketosteroids; D006907:17-alpha-Hydroxypregnenolone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D005043:Etiocholanolone; D000738:Androsterone; D003350:Cortodoxone