title: [A case of adrenocortical carcinoma with Cushing's syndrome presenting unusual urinary 17-ketosteroid fractionation].
abstract: A patient with adrenocortical carcinoma with Cushing's syndrome is presented. This case seems to be most characterized by its very unusual urinary 17-ketosteroid (KS) fractionation, since markedly increased etiocholanolone was not accompanied by increments of either DHEA or androsterone. Determination of the plasma adrenocorticosteroids of the patient revealed normal DHEA and DHEA-S levels, moderately increased 17-OH-pregnenolone, and markedly increased 11-deoxycortisol. Therefore, it seems plausible that the unique 17-KS fractionation of this patient would have ensued as a result of remarkably decreased C17-20 lyase activity sufficient to nullify the increased 17-OH-pregnenolone and that markedly increased etiocholanolone might have been converted from 11-deoxycortisol.
mesh_terms: D015065:17-Hydroxycorticosteroids / Q000652:urine*; D000306:Adrenal Cortex Neoplasms / Q000652:urine*; D000328:Adult; D000738:Androsterone / Q000652:urine; D003480:Cushing Syndrome / Q000652:urine*; D003687:Dehydroepiandrosterone / Q000652:urine; D005043:Etiocholanolone / Q000652:urine; D006801:Humans; D008297:Male; D012084:Renin-Angiotensin System
chemical_list: D015065:17-Hydroxycorticosteroids; D003687:Dehydroepiandrosterone; D005043:Etiocholanolone; D000738:Androsterone