Journal Article10.1007/BF03348975
Feminization as a result of both peripheral conversion of androgens and direct estrogen production from an adrenocortical carcinoma
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TL;DR: A 45-year-old man presented with gynecomastia, hypertension and a large left adrenal mass and it is estimated that about half the serum estrone arose from peripheral conversion of androstenedione.
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Abstract: A 45-year-old man presented with gynecomastia, hypertension and a large left adrenal mass. Further evaluation revealed elevated serum concentrations of estrogen, estrone sulfate, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, deoxycorticosterone, and aldosterone and increased 24-hour urinary 17-ketosteroid and free cortisol excretion. Removal of a 10 kg adrenocortical carcinoma led to normalization of the hormone concentrations and partial resolution of the gynecomastia. There was no clinical evidence of metastases. Incubation of tumor slices demonstrated that the tumor had an active aromatase and sulfotransferase. We estimated that about half the serum estrone arose from peripheral conversion of androstenedione. Feminizing adrenocortical carcinomas are rare and this case is unusual given the lack of clinical metastases and the probable dual source of estrogen from tumor as well as from the peripheral conversion of tumor-derived androgens.
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Citations
Aromatase and gynecomastia.
TL;DR: Although aromatase inhibition would appear to be an important class of drugs to treat gynecomastia, relatively little published data with these drugs exist and most concern the use of delta1-testolactone, which reduces the size of the breast glandular tissue, but does not completely ameliorate the problem.
Functional aromatase expression in porcine adrenal gland and testis.
Alan J Conley,C. J. Corbin,Margaret M. Hinshelwood,Zheng Liu,Evan R. Simpson,J. Joe Ford,Nobuhiro Harada +6 more
TL;DR: Fetal and newborn porcine adrenal glands and testes express an active P450arom that resembles the isoform expressed in the ovary, and the localization of adrenal expression suggests a possible role in medullary maturation and function in the fetal and newborn pig.
Adrenocortical Carcinoma: Review of the Pathologic Features, Production of Adrenal Steroids, and Molecular Pathogenesis
Yasuhiro Nakamura,Yuto Yamazaki,Saulo J.A. Felizola,Kazue Ise,Ryo Morimoto,Fumitoshi Satoh,Yoichi Arai,Hironobu Sasano +7 more
TL;DR: The current status of the histopathological diagnosis, molecular pathogenesis, and hormonal features of ACC are summarized.
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Male hypogonadism: more than just a low testosterone.
TL;DR: How to approach the finding of a low testosterone value, stressing the need to confirm the finding, the underlying pathophysiologic processes, drugs that can be responsible, and the importance of determining whether the cause is primary (testicular) or secondary (hypothalamic-pituitary).
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Feminizing adreno-cortical carcinomas in male adults. A dire prognosis. Three cases in a series of 801 adrenalectomies and review of the literature.
TL;DR: In this paper, the authors described the clinical presentation, biochemical features, diagnostic criteria, clinical course and differential diagnosis in three cases of feminizing adreno-cortical carcinoma (FACC) with a review of the literature Patients From 1970 throughout December 2003 among a series of 801 adrenalectomies, three had been performed for FACC.
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References
Pathophysiology of Male Hypogonadism Associated with Endogenous Hyperestrogenism — Evidence for Dual Defects in the Gonadal Axis
Johannes D. Veldhuis,James R. Sowers,Alan D. Rogol,Frederick A. Klein,Norman E. Miller,Maria L. Dufau +5 more
TL;DR: It is necessary to select patients suitable for vaginal or laparoscopic mesh placement for surgery on the basis of prior history and once they provide informed consent for surgery.
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Methods and Results of Aromatization Studies in Vivo
TL;DR: In men and postmenopausal women, peripheral aromatization of an androgen does not appear to be influenced by luteinizing hormone, follicle-stimulating hormone or adrenocorticotropic hormone or by substrate or product concentration.
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TL;DR: TUMORS derived from steroid hormone-producing cells of the adrenal, ovary, and testes are rare and important both as causes of disease entities and as useful model systems for the study of steroidogenesis.
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The production and aromatization of dehydroepiandrosterone in post-menopausal women☆
TL;DR: The peripheral aromatization of DHEA can be an important source of E1 in some women and the metabolic clearance rates (MCRD) and blood production rates (PDB) are similar to those reported for young women but PDB is less than those reports for younger women.
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