Feminizing Adrenocortical Carcinoma with Selective Suppression of Follicle-Stimulating Hormone Secretion and Disorganized Steroidogenesis: A Case Report and Literature Review
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概要
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We report a 61-year-old male with gynecomastia, poor libido and erectile dysfunction. Endocrinological studies showed high levels of estradiol and dehydroepiandrosterone sulfate. Although luteinizing hormone (LH) level was within the normal limit, the concentration of follicle-stimulating hormone (FSH) was under the normal limit. Delayed response of LH and poor response of FSH to gonadotropin-releasing hormone administration were detected. Magnetic resonance imaging of the abdomen revealed a left adrenal tumor. Although the surgically-resected tumor was diagnosed as a high grade ACC based on Weisss criteria of adrenocortical malignancy, no metastasis was detected. Since estrogen levels normalized after resection, feminizing ACC was confirmed. While LH concentration increased slightly after operation, FSH level became transiently elevated over the normal limit, and finally reached the normal range. These data may suggest that FSH was suppressed selectively by hormone produced by ACC different from estrogen.
著者
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Sasano Hironobu
Department Of Anatomic Pathology Tohoku University School Of Medicine
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Saito Takatoshi
Division Of Diabetes And Endocrinology Department Of Internal Medicine The Jikei University School O
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Utsunomiya Kazunori
Division Of Diabetes Metabolism And Endocrinology Department Of Internal Medicine Jikei University S
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Furuta Nozomu
Department Of Urology Aoto University Hospital Jikei University School Of Medicine
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Tojo Katsuyoshi
Division Of Diabetes And Endocrinology Department Of Internal Medicine Jikei University School Of Me
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Ono Katsuhiko
Department Of Anatomy Shimane Medical University
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Tojo Katsuyoshi
Division of Diabetes and Endocrinology, Department of Medicine, Jikei University School of Medicine, Japan
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Ono Katsuhiko
Department of Pathology, Tohoku University School of Medicine, Japan
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Utsunomiya Kazunori
Division of Diabetes and Endocrinology, Department of Medicine, Jikei University School of Medicine, Japan
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Saito Takatoshi
Division of Diabetes and Endocrinology, Department of Medicine, Jikei University School of Medicine, Japan
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