Feminizing Adrenocortical Carcinoma with Distinct Histopathological Findings

We herein present a 60-year-old man with adrenocortical carcinoma who had gynecomastia. An endocrinological examination revealed increased levels of serum estradiol and dehydroepiandrosterone-sulfate (DHEA-S) and reduced levels of free testosterone. Magnetic resonance imaging showed an adrenal tumor...

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Bibliographic Details
Published in:Internal Medicine 2016/11/15, Vol.55(22), pp.3301-3307
Main Authors: Hatano, Masako, Takenaka, Yasuhiro, Inoue, Ikuo, Homma, Keiko, Hasegawa, Tomonobu, Sasano, Hisanobu, Awata, Takuya, Katayama, Shigehiro
Format: Article
Language:English
Subjects:
Adrenal Cortex Neoplasms - complications
Adrenal Cortex Neoplasms - diagnosis
Adrenal Cortex Neoplasms - surgery
Adrenalectomy
adrenocortical carcinoma
Adrenocortical Carcinoma - complications
Adrenocortical Carcinoma - diagnosis
Adrenocortical Carcinoma - surgery
aromatase
Case Report
Dehydroepiandrosterone Sulfate - blood
estrogen-producing tumor
Feminization - etiology
gynecomastia
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Radionuclide Imaging
testosterone
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Summary:We herein present a 60-year-old man with adrenocortical carcinoma who had gynecomastia. An endocrinological examination revealed increased levels of serum estradiol and dehydroepiandrosterone-sulfate (DHEA-S) and reduced levels of free testosterone. Magnetic resonance imaging showed an adrenal tumor with heterogeneous intensity. Iodine-131 adosterol scintigraphy showed an increased uptake at the same site. Because feminizing adrenocortical carcinoma was suspected, right adrenalectomy was performed; the pathological diagnosis was adrenocortical carcinoma. The results of immunostaining indicated a virilizing tumor. Aromatase activity was identified on RT-PCR. As disorganized steroidogenesis is pathologically present in adrenocortical carcinoma, this diagnosis should be made with caution.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.5912