STUDIES OF 16-ANDROSTENES IN AN INFANT WITH VIRILIZING ADRENAL CARCINOMA

An 18-month-old girl with virilization was found to have an encapsulated right adrenal carcinoma (2 × 3 cm) with great variation in nuclear size, frequent mitoses, and possible blood vessel invasion. Preoperative urinary excretions of 17-ketosteroids, androsterone, etiocholanolone, dehydroepiandrosterone, testosterone, pregnanetriol, 3α-androstenol, and 3β-androstadienol were elevated; all showed a noticeable decrease postoperatively. Cortisol acetate, given preoperatively, produced a definite decrease in the urinary excretion of 17-ketosteroids and dehydroepiandrosterone; administration of corticotropin resulted in an increase in levels of urinary 17-ketosteroids, 17-hydroxycorticosteroids, and pregnanetriol. Urinary testosterone and 3β-androstadienol may have diagnostic value since neither was suppressed by cortisol therapy. The behavior of both 3α-androstenol and 3β-androstadienol in this study suggests that they are of adrenal origin. (Am J Dis Child 133:294-297, 1979. © 1979, American Medical Association. All rights reserved.