title: Feminizing adrenocortical carcinoma with selective suppression of follicle-stimulating hormone secretion and disorganized steroidogenesis: a case report and literature review.
abstract: We report a 61-year-old male with gynecomastia, poor libido and erectile dysfunction. Endocrinological studies showed high levels of estradiol and dehydroepiandrosterone sulfate. Although luteinizing hormone (LH) level was within the normal limit, the concentration of follicle-stimulating hormone (FSH) was under the normal limit. Delayed response of LH and poor response of FSH to gonadotropin-releasing hormone administration were detected. Magnetic resonance imaging of the abdomen revealed a left adrenal tumor. Although the surgically-resected tumor was diagnosed as a high grade ACC based on Weiss's criteria of adrenocortical malignancy, no metastasis was detected. Since estrogen levels normalized after resection, feminizing ACC was confirmed. While LH concentration increased slightly after operation, FSH level became transiently elevated over the normal limit, and finally reached the normal range. These data may suggest that FSH was suppressed selectively by hormone produced by ACC different from estrogen.
authors: Division of Diabetes and Endocrinology, Department of Medicine, Jikei University School of Medicine, Japan. tsaito@jikei.ac.jp
authors: Takatoshi
authors: T
authors: Saito
authors: Katsuyoshi
authors: K
authors: Tojo
authors: Nozomu
authors: N
authors: Furuta
authors: Katsuhiko
authors: K
authors: Ono
authors: Hironobu
authors: H
authors: Sasano
authors: Kazunori
authors: K
authors: Utsunomiya
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism*; D018268:Adrenocortical Carcinoma / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism*; D001141:Aromatase / Q000235:genetics; D005262:Feminization / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism*; D005640:Follicle Stimulating Hormone / Q000037:antagonists & inhibitors* / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D005640:Follicle Stimulating Hormone; D001141:Aromatase; C561410:CYP19A1 protein, human