Studies of Androgens in Patients with Adrenocortical Tumors

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Abstract
Seven patients with adrenal tumors have been studied. Two of them showed signs of feminization, 4 demonstrated only symptoms of masculinization, and 1 had a nonfunctional tumor. Peripheral and adrenal vein plasma concentrations of testosterone (T), androstenedione (Δ), dehydroepiandrosterone (D), its sulfate (DS) and glucuronide (DG) conjugates, androsterone sulfate (AS) and glucuronide (AG), and etiocholanolone sulfate (ES) and glucuronide (EG) were determined. Adrenal secretion of T, Δ, D and DS was established on the basis of differences in steroid concentrations in peripheral and adrenal vein blood. None of the other androgen conjugates (AS, AG, ES and EG) were found to be secreted by the adrenal tumors. When considering the age and sex of the patients, the concentrations in peripheral vein plasma of T, Δ, D and DS were increased in all subjects studied except for a normal level of T and D in 1 of the 2 patients with symptoms of feminization. Fractionation of urinary steroids in 3 patients with masculinization and 2 with feminization showed: an increase in DS and pregnanediol in all subjects, normal pregnanetriol and 17-hydroxycorticosteroids in all patients except for 1 subject with feminization, an elevated estrogen excretion in the 2 patients with feminization, and an increased urinary testosterone glucuronide in all subjects except 1 of the 2 patients with feminization.