ADRENOCORTICAL CARCINOMA WITH GYNECOMASTIA: A CASE REPORT AND REVIEW OF THE LITERATURE

Abstract

In addition to the gynecomastia which characterizes this syndrome, testicular atrophy, reduced libido and potency, and the presence of a palpable tumor were frequently seen. Nineteen of 34 reported patients developed metastases. Laboratory evidence of relative adrenocortical insufficiency was found in the present case and was believed to be present in a small per cent of previously described patients. Urinary excretion of chorionic gonadotropin was usually absent and excretion of pituitary gonadotropin (FSH) normal or reduced. Increased excretion of biologically active estrogen and of 17-ketosteroid were seen in 50 and 33%, respectively, of reported cases. Estradiol, estrone, estriol, pregnanediol, and dehydroisoandrosterone were isolated from urine by various investigators. In the present case, Salhanick and Berliner isolated progesterone, equilenin, and 6 incompletely characterized steroids from the excised tumor. These findings give further evidence of the multiplicity of steroidogenic processes possible in adrenocortical and other tissues.