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April 1968, Vol 115, No. 4 >
Article | April 1968

Virilizing Tumors of the Adrenal Cortex FREE

Frederic M. Kenny, MD; Yoshie Hashida, MD; H. Ali Askari, MD; William H. Sieber, MD; George H. Fetterman, MD
[+] Author Affiliations

Received for publication May 8, 1967.

Reprint requests to 125 DeSoto St, Pittsburgh 15213 (Dr. Kenny).


Am J Dis Child. 1968;115(4):445-458. doi:10.1001/archpedi.1968.02100010447007.
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References
Comments

FUNCTIONING neoplasms of the adrenal cortex are clinically manifested by virilization, Cushing's syndrome, feminization, or hyperaldosteronism. In the present report, seven patients with virilizing adrenal tumors are described. In one case, virilization was present from birth. This is a unique instance of in utero virilization attributable to a tumor. Other unusual clinical, pathological, and laboratory findings are being reported.

Methods  The method used for 17-ketosteroid (17-KS) measurements was a modification of that of Callow et al.1 The procedure of Allen et al2 was used for dehydroisoandrosterone (DHA). Pregnanetriol was measured at the BioScience Laboratories, Los Angeles, by Cox's method.3 The 17-hydroxycorticosteroids (17-OHCS) were measured by a modification4 of the method of Glenn and Nelson.5 Aldosterone was estimated in patient 1 by a modification of the procedure of Neher and Wettstein.6 Cathecholamines were measured by the method of Jacobs et al,7 and vanillyl mandelic acid as described

REFERENCES

1 +
Callow, N.H.; Callow, R.K.; and Emmens, C.W.:  Colorimetric Determination of Substances Containing Grouping—CH2CO—in Urine Extracts as indication of Androgen Content , Biochem J 32:1312, 1938;.
2 +
Allen, W.M.; Hayward, S.J.; and Pinto, A.:  A Color Test for Dehydroisoandrosterone and Closely Related Steroids of Use in the Diagnosis of Adrenocortical Tumors , J Clin Endoc 10:54, 1950;.
3 +
Cox, R.I.:  A Method for the Quantitative Determination in Urinary Extracts of C 21, 17:20-Dehydroxy-20-Methyl Steroids , Biochem J 52:339, 1952;.
4 +
Kenny, F.M.; Malvaux, P.; and Migeon, C.J.:  Cortisol Production in Newborn Babies, Older Infants and Children , Pediatrics 31:360, 1963;.
5 +
Glenn, E.M., and Nelson, D.H.:  Chemical Method for the Determination of 17-Hydroxycorticosteroids and 17-Ketosteroids in Urine Following Hydrolysis with β-Glucuronidase , J Clin Endocr 13: 911, 1953;.
6 +
Neher, R., and Wettstein, A.:  Physicochemical Estimation of Aldosterone in Urine , J Clin Invest 35:800, 1956;.
7 +
Jacobs, S.L.; Sobel, C.; and Henry, R.J.J.:  Specificity of the Trihydroxyindole Method for Determination of Urinary Catecholamines , J Clin Endocr 21:305, 1961;.
8 +
Sunderman, F.W., et al:  A Method for the Determination of 3-Methoxy-4-Hydroxymandelic Acid ("Vanillyl Mandelic Acid") for the Diagnosis of Pheochromocytoma , Amer J Clin Path 34:293, 1960;.
9 +
Weber, E.J., and Menten, M.L.:  Histologic Studies on a Virilizing Tumor of the Adrenal Cortex , Amer J Path 24:293, 1948;.
10 +
Hayles, A.B., et al:  Hormone Secreting Tumors of the Adrenal Cortex in Children , Pediatrics 37:19, 1966;.
11 +
Gross, R.E.:  Neoplasma Producing Endocrine Disturbances in Childhood , Amer J Dis Child 59: 579, 1940;.
12 +
Goldstein, A.E.; Rubin, S.W.; and Askin, J.A.:  Carcinoma of Adrenal Cortex with Adrenogenital Syndrome in Children: Complete Review of the Literature and Report of a Case with Recovery in a Child 8 Months of Age , Amer J Dis Child 72: 563, 1946;.
13 +
Rapoport, E., et al:  Mortality in Surgically Treated Adrenocortical Tumors: II. Review of Cases Reported for the 20 Year Period 1930-1949 Inclusive , Postgrad Med 11:325, 1952;.
14 +
McFarlane, D.A.:  Cancer of the Adrenal Cortex. The Natural Histories, Prognosis and Treatment in a Study of Fifty-five Cases , Ann Roy Coll Surg Eng 23:155, 1958;.
15 +
Currie, A.R.; Symington, T.; and Grant, J.K.: Conference on the Human Adrenal Cortex , Edinburgh: E. & S. Livingstone, Ltd., 1962;.
16 +
Craig, J.M., and Landing, B.H.:  Anaplastic Cells of Fetal Adrenal Cortex , Amer J Clin Path 21:940, 1951;.
17 +
Potter, E.L.: Pathology of Fetus and the Newborn , ed 1, Chicago: Year Book Medical Publishers, Inc., 1952;, p 284.
18 +
Sherman, F.E.; Bass, L.W.; and Fetterman, G.H.:  Congenital Metastasizing Adrenal Cortical Carcinoma Associated With Cytomegaly of the Fetal Adrenal Cortex , Amer J Clin Path 30:439, 1958;.
19 +
Lipsett, M.B.; Hertz, R.; and Ross, G.T.:  Clinical and Pathophysiologic Aspects of Adrenocortical Carcinoma , Amer J Med 35:374, 1963;.
20 +
Heinbecker, P.; O'Neil, L.W.; and Ackerman, L.V.:  Functional and Nonfunctional Adrenal Cortical Tumor , Surg Gynec Obstet 105:21, 1957;.

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References

1 +
Callow, N.H.; Callow, R.K.; and Emmens, C.W.:  Colorimetric Determination of Substances Containing Grouping—CH2CO—in Urine Extracts as indication of Androgen Content , Biochem J 32:1312, 1938;.
2 +
Allen, W.M.; Hayward, S.J.; and Pinto, A.:  A Color Test for Dehydroisoandrosterone and Closely Related Steroids of Use in the Diagnosis of Adrenocortical Tumors , J Clin Endoc 10:54, 1950;.
3 +
Cox, R.I.:  A Method for the Quantitative Determination in Urinary Extracts of C 21, 17:20-Dehydroxy-20-Methyl Steroids , Biochem J 52:339, 1952;.
4 +
Kenny, F.M.; Malvaux, P.; and Migeon, C.J.:  Cortisol Production in Newborn Babies, Older Infants and Children , Pediatrics 31:360, 1963;.
5 +
Glenn, E.M., and Nelson, D.H.:  Chemical Method for the Determination of 17-Hydroxycorticosteroids and 17-Ketosteroids in Urine Following Hydrolysis with β-Glucuronidase , J Clin Endocr 13: 911, 1953;.
6 +
Neher, R., and Wettstein, A.:  Physicochemical Estimation of Aldosterone in Urine , J Clin Invest 35:800, 1956;.
7 +
Jacobs, S.L.; Sobel, C.; and Henry, R.J.J.:  Specificity of the Trihydroxyindole Method for Determination of Urinary Catecholamines , J Clin Endocr 21:305, 1961;.
8 +
Sunderman, F.W., et al:  A Method for the Determination of 3-Methoxy-4-Hydroxymandelic Acid ("Vanillyl Mandelic Acid") for the Diagnosis of Pheochromocytoma , Amer J Clin Path 34:293, 1960;.
9 +
Weber, E.J., and Menten, M.L.:  Histologic Studies on a Virilizing Tumor of the Adrenal Cortex , Amer J Path 24:293, 1948;.
10 +
Hayles, A.B., et al:  Hormone Secreting Tumors of the Adrenal Cortex in Children , Pediatrics 37:19, 1966;.
11 +
Gross, R.E.:  Neoplasma Producing Endocrine Disturbances in Childhood , Amer J Dis Child 59: 579, 1940;.
12 +
Goldstein, A.E.; Rubin, S.W.; and Askin, J.A.:  Carcinoma of Adrenal Cortex with Adrenogenital Syndrome in Children: Complete Review of the Literature and Report of a Case with Recovery in a Child 8 Months of Age , Amer J Dis Child 72: 563, 1946;.
13 +
Rapoport, E., et al:  Mortality in Surgically Treated Adrenocortical Tumors: II. Review of Cases Reported for the 20 Year Period 1930-1949 Inclusive , Postgrad Med 11:325, 1952;.
14 +
McFarlane, D.A.:  Cancer of the Adrenal Cortex. The Natural Histories, Prognosis and Treatment in a Study of Fifty-five Cases , Ann Roy Coll Surg Eng 23:155, 1958;.
15 +
Currie, A.R.; Symington, T.; and Grant, J.K.: Conference on the Human Adrenal Cortex , Edinburgh: E. & S. Livingstone, Ltd., 1962;.
16 +
Craig, J.M., and Landing, B.H.:  Anaplastic Cells of Fetal Adrenal Cortex , Amer J Clin Path 21:940, 1951;.
17 +
Potter, E.L.: Pathology of Fetus and the Newborn , ed 1, Chicago: Year Book Medical Publishers, Inc., 1952;, p 284.
18 +
Sherman, F.E.; Bass, L.W.; and Fetterman, G.H.:  Congenital Metastasizing Adrenal Cortical Carcinoma Associated With Cytomegaly of the Fetal Adrenal Cortex , Amer J Clin Path 30:439, 1958;.
19 +
Lipsett, M.B.; Hertz, R.; and Ross, G.T.:  Clinical and Pathophysiologic Aspects of Adrenocortical Carcinoma , Amer J Med 35:374, 1963;.
20 +
Heinbecker, P.; O'Neil, L.W.; and Ackerman, L.V.:  Functional and Nonfunctional Adrenal Cortical Tumor , Surg Gynec Obstet 105:21, 1957;.

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