Individual 17-Ketosteroid Excretion in a Case of Arrhenoblastoma and Its Response to Corticotrophin and Human Chorionic Gonadotrophin Stimulation and to Dexamethasone Inhibition

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Abstract
Individual 17-ketosteroid (17-KS) excretion and its response to dexamethasone (DXM) inhibition as well as corticotrophin (ACTH) and human chorionic gonadotrophin (HCG) stimulation was measured by paper chromatography in a case of arrhenoblastoma. The pattern of the excretion was within normal limits on 2 control days. After ACTH stimulation there was an increase of dehydroepiandrosterone (DEA) and of 11-oxy-17-ketosteroids (ll-oxy-17-KS) only. No change of androsterone (A) and etiocholanolone (E) was noted. On dexamethasone suppression a marked drop of all components was observed. DEA and ll-oxy-17-KS excretion was very low throughout the suppression period. There was also a pronounced decrease in the excretion of the A and E fraction, its value being 0.840-1.680 mg. HCG stimulation had no effect on the excretion of any of the 17-KS. On the grounds of these results it was thought that neither the excretion pattern at rest nor the DXM suppression test could facilitate the diagnosis of the tumor preoperatively. The hypothesis , however, is advanced that a negative HCG test under adrenal suppression in a case of marked hirsutism would indicate that the hirsutism is due to either adrenal pathology or ovarian tumor.

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