17-ketosteroids and Carcinoma

We have experienced two male cases of an adrenocortical carcinoma that have produced steroid hormones without endocrinological symptoms. Both men were admitted to hospital because of an abdominal pain and left hypochondral tumors. In each case, an abdominal CT, an ultrasonogram and an angiogram demonstrated a left adrenal tumor, and levels of blood dehydroepiandrosterone sulfate, etiocholanolone, pregnenolone sulfate and urine 17 KS were elevated. The tumors were resected and the histology revealed that they were adrenocortical carcinomas. Postoperatively, the levels of their urine hormones returned to normal values, though in one man recurrence occurred a year later. Only 8 cases of an adrenocortical carcinoma that has produced steroids without specific endocrinological symptoms have been reported in Japan, and we also report on two cases herein.

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Cortex Neoplasms; Adult; Carcinoma; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Etiocholanolone; Humans; Male; Pregnenolone

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Adult; Androgens; Carcinoma; Child, Preschool; Cushing Syndrome; Estrogens; Female; Feminization; Glucocorticoids; Granulosa Cell Tumor; Humans; Leydig Cell Tumor; Male; Mesenchymoma; Middle Aged; Mitotane; Ovarian Neoplasms; Paraneoplastic Endocrine Syndromes; Pregnancy; Progesterone; Prognosis; Sertoli Cell Tumor; Steroids; Testicular Neoplasms; Thecoma; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Aged; Blood Chemical Analysis; Carcinoma; Clinical Trials as Topic; Cushing Syndrome; Female; Humans; Hyperplasia; Male; Metyrapone; Middle Aged; Pregnanes

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Insufficiency; Carcinoma; Clinical Trials as Topic; Cushing Syndrome; Depression, Chemical; Female; Humans; Middle Aged; Natriuresis; Phenethylamines; Pregnanes; Water-Electrolyte Balance

We report a case of preclinical Cushing's syndrome in a 54-year-old male associated with bilateral adrenocortical tumours. Physical findings and general laboratory data were unremarkable except for mild hypertension (158/90 mmHg) and impaired glucose tolerance. Endocrinological evaluation revealed the presence of autonomous cortisol secretion including unsuppressible serum cortisol by 8 mg dexamethasone test (11 microg/dl), high serum DHEA-S (3580 ng/ml, normal: 400-3500) and increased urinary 17-KS excretion (31.0-35.8 mg/day, normal: 5.8-21.3). CT scan demonstrated the presence of tumours in both adrenals and bilateral adrenalectomy was subsequently performed. Histological examination of the resected specimens revealed an adrenocortical carcinoma on the right side and an adenoma on the left side with noticeable cortical atrophy in non-neoplastic adrenals. Immunohistochemical study of steroidogenic enzymes demonstrated that all the steroidogenic enzymes involved in cortisol biosynthesis were expressed in both right and left adrenal tumours. Enzymatic activities of 21, 17alpha, 18, 11beta-hydroxylases were detected in both right and left adrenals except for the absence of 11beta-hydroxylase activity in the left adrenal adenoma. Results of in vitro tissue steroidogenesis examined in short-term tissue culture of the specimens revealed no significant differences between carcinoma and adenoma in cortisol production, but the production of adrenal androgens in carcinoma was significantly higher than that in adenoma, which may indicate the importance of evaluating adrenal androgen levels in patients with adrenocortical neoplasms.

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Neoplasms; Adrenalectomy; Carcinoma; Culture Techniques; Cushing Syndrome; Dehydroepiandrosterone Sulfate; Dexamethasone; Glucocorticoids; Humans; Hydrocortisone; Immunohistochemistry; Male; Middle Aged; Neoplasms, Multiple Primary; Steroid Hydroxylases; Tomography, X-Ray Computed

Adrenal tumors showing no clinical manifestations (incidentaloma) are frequently encountered during imaging analysis upon routine examinations. These tumors are sometimes associated with hypertension and/or diabetes mellitus (DM). We have examined six cases of incidentalomas with these symptoms in this study. All patients underwent endocrinological evaluation by measuring plasma cortisol and aldosterone levels to assess adrenocortical function. The levels of urinary 17-hydroxysteroids, 17-ketosteroids and catecholamines were also measured. Imaging analysis were performed by using 131I-adosterol scintigraphy, computed tomography and magnetic resonance imaging. Whereas one case was diagnosed as having an adrenal adenoma without the examination of a surgical specimen, other cases underwent surgical removal of the tumor, and final diagnoses were made by pathohistological examination of the tumors. Three cases were diagnosed as having adrenocortical adenomas (one was functioning and others were non-functioning) and one case was diagnosed as having a functional adrenocortical carcinoma. Adenomas were found to produce either non-functional steroids or a small amount of functional steroid hormones. The adenoma patients all suffered hypertension, whereas one of the adenoma patients and the carcinoma patient showed signs of DM. By contrast, of the six cases, one case was diagnosed as having an adrenal cyst, and one case was diagnosed with myelolipoma. Although these two cases suffered DM and hypertension, respectively, it seemed to be unlikely that these clinical symptoms were caused by the adrenal disease. Thus, the present analysis of the six incidentaloma patients suggests that once an adrenal incidentaloma patient with hypertension and/or DM is found, both endocrinological and imaging examinations are necessary to determine the indication of surgical treatment. This analysis supports the present consensus that non-functional adenomas whose sizes are 3cm or less and whose sizes do not change at any reevaluation period, as well as adrenal cysts and myelolipoma should not be surgically removed.

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Aged; Aldosterone; Carcinoma; Catecholamines; Cushing Syndrome; Diabetes Mellitus; Female; Humans; Hydrocortisone; Hydroxysteroids; Hypertension; Male; Middle Aged

Hirsutism in women is usually caused by benign adrenal or ovarian disorders, but it can also be caused by adrenal carcinoma. The most effective way to identify such carcinomas is not known.. We measured serum and urinary steroids before and after the administration of 3 mg of dexamethasone per day for five days in 14 hirsute women with histologically proved adrenal tumors (12 adrenal carcinomas and 2 adrenal adenomas) and in 73 women with hirsutism of non-neoplastic origin.. All the women with adrenal tumors had elevated basal serum concentrations of testosterone or dehydroepiandrosterone sulfate, as compared with 36 of the 73 women with non-neoplastic hirsutism (sensitivity, 100 percent; 95 percent confidence interval, 77 to 100; specificity, 50 percent; 95 percent confidence interval, 38 to 62). After the administration of dexamethasone, serum dehydroepiandrosterone sulfate concentrations and urinary 17-ketosteroid excretion decreased to values similar to those in normal women in all the women with non-neoplastic hirsutism, but in none of the 12 with adrenal tumors who were tested. All the women who did not have adrenal tumors had serum cortisol concentrations below 3.3 micrograms per deciliter (90 nmol per liter) after dexamethasone administration, whereas in all 12 patients tested who had tumors the values were higher. The suppression of serum dehydroepiandrosterone sulfate and cortisol and urinary 17-ketosteroid excretion excluded the likelihood of adrenal tumors with a sensitivity of 100 percent (95 percent confidence interval, 74 to 100) and a specificity of 100 percent (95 percent confidence interval, 89 to 100).. Among women with hirsutism, an adrenal tumor is unlikely if the patient has normal basal serum concentrations of testosterone and dehydroepiandrosterone sulfate. In women in whom these concentrations are elevated, a tumor is unlikely if the serum concentration of dehydroepiandrosterone sulfate and urinary 17-ketosteroid excretion are in the normal basal range and the serum cortisol concentration is less than 3.3 micrograms per deciliter after the administration of dexamethasone.

Topics: 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adult; Androstenedione; Carcinoma; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Dexamethasone; Female; Follicle Stimulating Hormone; Hirsutism; Humans; Hydrocortisone; Luteinizing Hormone; Middle Aged; Reference Values; Testosterone

A 24-year-old man visited our hospital complaining of hypertension and headache. Endocrinological findings revealed no abnormalities except for a slight decrease in serum adrenocorticotropic hormone (ACTH), a slight increase in urine 17-ketosteroid (17-KS), and a marked increase in serum pregnenolone. Computed tomography and magnetic resonance imaging revealed a 3 x 3 cm mass in the right adrenal area and I131-aldosterol scintigraphy demonstrated a high absorption of the isotope in the right adrenal area. Vena cavography suggested a 2 x 2 cm tumor thrombus originating in the right adrenal. Under the diagnosis of the right adrenocortical carcinoma, adrenalectomy and removal of the tumor thrombus were performed. Both serum pregnenolone and urine 17-KS returned to the normal level within a week after the operation and blood pressure was well controlled without any medication 3 months after the operation. Thus, the tumor seemed to be endocrinologically active.

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Carcinoma; Humans; Iodine Radioisotopes; Magnetic Resonance Imaging; Male; Pregnenolone; Radionuclide Imaging; Tomography, X-Ray Computed; Venae Cavae

Ten patients with adrenal cortical carcinoma were treated from 1966 to 1986. There were 7 males and 3 females. The typical clinical manifestations, marked increase of 17-ketosteroid, 17-hydroxycorticoids and DHA, and negative dexamethasone suppression test were essential for the diagnosis. Of the ten patients, eight had secretive function and their 17-ketosteroid and 17-hydroxycorticoids varied from 36.8-93 mg% and 32.5-150 mg%, respectively. DHA was measured in 5 cases with the result of 6.95-44mg%. Those without secretive functions or obvious endocrine disturbances were usually misdiagnosed as kidney tumor, splenomagaly, liver tumor or pancreatic mass. Wood had summarized that nonsecretive ACC patients commonly had fever, pain, exhaustion syndrome (emaciation, fatigue, perspiration, anorexia), mass and distant metastasis. Adrenal scan, IVU, abdominal aortic arteriography, retroperitoneal pneumography and CT were helpful in localization. The differential diagnosis between ACC and adenoma by pathology was difficult. It is generally agreed that if the mass is larger than 100 grams, capsulated, having blood or lymphatic vessel invasion, hemorrhage, necrosis and calcification or even distant metastasis, malignant tumor should be considered. Surgical removal of the tumor is the only effective treatment. For advanced or recurrent lesions, selective adrenal artery thrombosis could be used. One of the ten patients was thus treated by this facilitated subsequent surgery. Postoperative chemotherapy, such as O.P-DDD, might be used in some cases.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Neoplasms; Adult; Aged; Carcinoma; Dehydroepiandrosterone; Diagnosis, Differential; Female; Humans; Male; Middle Aged

A 36-year-old woman who had experienced two pregnancies consulted our hospital, because of scant menses and virilization. A 24-hour excretion of 17-ketosteroids and 17-hydroxy-corticosteroids demonstrated a decrease in 11-hydroxylase. A computed tomogram showed a huge inhomogenous tumefaction in the left adrenal. Left selective renal angiography revealed a large adrenal tumefaction. Selective adrenal venous samplings revealed that testosterone and dehydroepiandrosterone (DHA) were produced in response to stimulation by 0.25 mg exogenous adrenocorticotropic hormone (ACTH). After left adrenalectomy was performed, a diagnosis of adrenocortical carcinoma was made by pathological examination. This is the first report of a patient with a virilizing adrenocortical carcinoma, which produced testosterone and DHA in response to exogenous ACTH stimulation.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Adult; Carcinoma; Dehydroepiandrosterone; Female; Humans; Testosterone; Tomography, X-Ray Computed; Virilism

The experience with adrenocortical neoplasms in childhood is reviewed. During three decades, ten children with adrenocortical neoplasms were seen at the authors' institution. The literature was reviewed, and 209 patients 16.5 years or younger were found. All ten patients at Vanderbilt University Hospital (VUH) presented with endocrine manifestations of the tumor. Three patients had Cushing's, two patients had virilization, and five patients had features of both. In the literature, virilization, alone or with Cushing's, was the most common mode of presentation. Feminizing tumors were uncommon and nonfunctional tumors rare. The majority of patients were female. Features associated with malignancy included 17-KS levels greater than 40 mg/24 hr, diameter greater than 6 cm, weight greater than 500 g, and histologic evidence of diffuse growth pattern, vascular invasion, and tumor cell necrosis. Although uncommon, adrenocortical neoplasms should be suspected in children with Cushing's, virilization, feminization, or a combination of these. There has been an increased incidence reported in patients with hemihypertrophy, Beckwith-Wiedemann syndrome, hemangiomas, and nevi. Following endocrinologic evaluation, imaging studies should be performed. CT scan appears to be the most useful diagnostic tool. A posterior operative approach is recommended for suspected adenomas. An anterior thoracoabdominal approach is favored for suspected malignancies with uncompromised en bloc resection. There is no evidence that adjuvant therapy provides any additional benefit.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Cortex Neoplasms; Carcinoma; Child; Child, Preschool; Cushing Syndrome; Female; Hirsutism; Humans; Hypertrophy; Infant; Male; Prognosis

Steroid excretion in urine of 12 infants with virilising adrenal tumours has been determined using gas chromatography. In six children, (Group A, five female, one male) aged 2.8-5.3 years, very high urinary excretions of 17 oxosteroids (greater than 40 mumol/24 h) were largely accounted for by dehydroepiandrosterone (DHA). In one of the girls, the pattern of steroids excreted in urine was similar to that of newborn infants, with high excretions of 16-oxygenated derivatives of DHA. The histology of this tumour suggested a neoplasia of fetal-type adrenocortical cells. Very large tumours were found in three of the infants, two of whom have died and one has multiple metastases. From the other three children, small, well-encapsulated adenomas were successfully removed. Six children (Group B), had moderately elevated 17-oxosteroid excretions (8-17 mumol/24 h). In five of these cases (four female, one male) aged 0.8-5 years, 11 beta-hydroxyandrosterone was a consistently prominent urinary steroid. In one boy, aged 7.7 years, 17-oxosteroid excretion was 15 mumol/24 h and the major steroids in urine were metabolites of pregnenolone. These six children have survived with no clinical evidence of recurrent tumour. The in vivo functional activities of the tumours can be deduced from the different profiles of steroids in urine. These have revealed heterogeneous patterns of steroid biosynthesis.

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Androsterone; Carcinoma; Child; Child, Preschool; Chromatography, Gas; Dehydroepiandrosterone; Female; Humans; Infant; Male; Steroids

With the wider application of increasingly sensitive computed tomographic scans, more adrenal masses will be discovered incidentally. Because benign lesions of the adrenal are much commoner than malignant ones, an approach is needed to determine which incidentally discovered masses should be removed. The history and physical examination may guide the evaluation. Imaging studies and needle biopsies have limited value. If the history and physical findings do not suggest a diagnosis, an approach using the size of the mass, results of any cyst puncture, and a biochemical assessment may determine which patients should have surgery. This approach is based on the relative prevalence of benign and malignant clinically silent adrenal tumors.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Cortex Neoplasms; Adrenal Gland Neoplasms; Biopsy, Needle; Carcinoma; Diagnosis, Differential; Female; Humans; Male; Pheochromocytoma; Sex Factors; Tomography, X-Ray Computed

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adult; Carcinoma; Cushing Syndrome; Female; Humans; Hydrocortisone; Infant; Male; Middle Aged

Topics: 17-Ketosteroids; Adenocarcinoma; Adrenal Cortex Neoplasms; Adult; Carcinoma; Cushing Syndrome; Female; Humans; Middle Aged

Topics: 17-Ketosteroids; Adrenal Cortex Neoplasms; Adrenal Glands; Adrenal Hyperplasia, Congenital; Atrophy; Carcinoma; Child; Female; Humans; Virilism

A 28 year old white women was found to have a cervical tumor in the 25th week of pregnancy. Pathologic examination revealed a nonkeratinizing small cell carcinoma. After delivery by cesarean section, pelvic lymph node exploration was carried out, and all 15 nodes were free of tumor. Her condition was staged as II-A, and she was treated with local radiation. Metastatic disease became manifest almost a year later and was histologically similar to her primary disease. A Cushingoid appearance was noticed and plasma cortisol levels were elevated. Twenty-four hour urinary 17-hydroxycorticosteroid (17-OHCS) and 17-ketosteroid (17-KS) levels were elevated and failed to suppress with dexamethasone. Plasma adrenocorticotropin (ACTH) level was elevated. Electron microscopic examination of the tumor tissue revealed neurosecretory granules. Immunoperoxidase stains for ACTH were positive. The patient's course was one of progressive decline and eventual death. A literature review revealed two other cases in which carcinoma of the uterine cervix was considered to be the source of ectopic ACTH. Some small cell carcinomas of the cervix may arise from cells of the APUD series. Small cell carcinoma of the uterine cervix may behave differently from the more commonly encountered keratinizing and large cell nonkeratinizing carcinomas of the cervix and may not respond as well to standard therapy. Ectopic hormone production, production of abnormal peptides or of vasoactive amines may be more common in small cell carcinoma of the cervix than is currently recognized, and these products may be clinically useful as tumor markers.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; ACTH Syndrome, Ectopic; Adult; APUD Cells; Carcinoma; Cushing Syndrome; Female; Humans; Hydrocortisone; Paraneoplastic Endocrine Syndromes; Pregnancy; Pregnancy Complications; Uterine Cervical Neoplasms

Patients with breast cancer in stage I--II of various histological structure showed varied hormonal disturbances. In adenocarcinoma a high level of classic estrogens or total phenolsteroids was noted. In low differentiated cancers (solid, scirrhus) the values of estrogens excretion were considerably lower, but, if correlated with other hormones (androsterone), a relative hyperestrogenization is observed. Scirrhous cancers are characterized by the increased 17-ketogenic steroids excretion. The character of hormonal disturbances concomitant with the predominant development of certain breast tumor structures (adenocarcinoma, solid cancer, scirrhus) is identical for the patients being in their reproductive and menopausal period.

Topics: 17-Ketosteroids; Adenocarcinoma; Adenocarcinoma, Scirrhous; Adult; Breast Neoplasms; Carcinoma; Estrogens; Female; Gonadotropins; Humans; Menopause; Menstruation; Middle Aged; Steroids; Sterols

Twenty-one patients with adrenocortical carcinoma (ACC) diagnosed at three hospitals over a ten-year period were reviewed for clinical and pathologic features that might have therapeutic implications. Depending upon the extent of cellular pleomorphism, ACC could be defined as anaplastic or differentiated. Anaplastic ACC occurred more often in male patients, produced more frequent cutaneous metastases (P = 0.01), and was associated with a lack of clinical or laboratory evidence of hormone production (P = 0.01). In contrast, differentiated ACC usually occurred in women and produced clinical or laboratory evidence of hormonal excess. Median survival time of patients with anaplastic ACC was only five months, while median survival time of those with differentiated ACC was 40 months (P = 0.005). Patients with differentiated ACC survived for long periods, even with metastatic disease. Three of 5 such patients had objective responses to o,p'-DDD (Mitotane) therapy. The histopathology of ACC is an important prognostic factor and should be considered in the design of future therapeutic trials.

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Neoplasms; Adult; Aged; Carcinoma; Cell Transformation, Neoplastic; Female; Humans; Hydrocortisone; Hydroxysteroids; Male; Middle Aged; Prognosis; Retrospective Studies; Time Factors

An 18-month-old girl with virilization was found to have an encapsulated right adrenal carcinoma (2 x3 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, 3alpha-androstenol, and 3 beta-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 3beta-androstadienol may have diagnostic value since neither was suppressed by cortisol therapy. The behavior of both 3alpha-androstenol and 3beta-androstadienol in this study suggests that they are of adrenal origin.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Androstenes; Carcinoma; Dehydroepiandrosterone; Female; Humans; Infant; Testosterone; Virilism

Four post-menopausal women had Cushing's syndrome due to adrenal cortical carcinomas. Comprehensive analyses of blood and urinary steroids showed that although the steroid profiles differed between patients, the pattern in each patient remained almost constant as the disease progressed, or remitted due to therapy. Elevations of serum testosterone and oestradiol were commensurate with the extent of virilisation, and the urinary output of aldosterone was associated with the severity of hypertension. A new finding was that all had substantially increased urinary free deoxycorticosterone. Complete surgical removal of the primary tumours was impossible but when most of the tumour tissue was removed, full clinical and biochemical remissions were obtained for a short time in 2 patients. One patient obtained a clinical and biochemical remission from op'DDD. In another patient the drug caused reduction both in blood pressure and in urinary aldosterone excretion, but there were unpleasant side effects. A third patient could not tolerate op'DDD. Metyrapone therapy produced neither clinical nor biochemical improvement in 3 patients. The mean duration of survival was 17 months after the first symptoms and 10 months from the date of operation. Despite advances in drug therapy, adrenal cortical carcinoma remains a lethal disease. Biochemical screening of multiple steroids offers a means of early diagnosis and disease monitoring. Extensive surgical removal of the tumour offers the best chance of a clinical and biochemical remission.

Topics: 17-Ketosteroids; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Aldosterone; Carcinoma; Cortodoxone; Cushing Syndrome; Desoxycorticosterone; Electrolytes; Estradiol; Female; Humans; Hydrocortisone; Luteinizing Hormone; Metyrapone; Middle Aged; Mitotane; Pregnanetriol; Testosterone

Pituitary adenoma was suspected in a woman of 74 with hypercorticism,hypokalaemic alkalosis and radiographically enlarged sella turcica. However, non-suppressibility of steroid excretion by high-dose dexamethasone and low plasma concentration of ACTH suggested adrenal tumour. Detailed analysis of urinary steroid excretions demonstrated unusually large amounts of corticosterone metabolites, 14.6 mg/24 h compared to a mean normal value of 0.5 mg. The basal levels of the remaining pituitary hormones were unremarkable. The patient died incidentally before a planned adrenalectomy. The autopsy disclosed an adrenal carcinoma and an empty sella turcica. The enlarged pituitary fossa was lined by a narrow rim of histological normal pituitary tissue.

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Aged; Carcinoma; Corticosterone; Dexamethasone; Empty Sella Syndrome; Female; Humans; Hydrocortisone; Sella Turcica

Medullary carcinoma of the thyroid (MCT) is reported to synthesize ACTH. This ACTH is believed to be responsible for the development of Cushing's syndrome in some patients with MCT. To determine the frequency of occurrence of adrenal cortical overactivity in patients with MCT, we measured plasma cortisol concentration and the urinary excretion of 17-hydroxycorticosteroids, 17-ketosteroids and urinary free cortisol in 22 patients with MCT and 7 patients with MCT plus pheochromocytomas. The patients with MCT and MCT plus pheochromocytoma had similar adrenal cortical function to age and sex matched normal subjects. We conclude that adrenal cortical function is usually normal in patients with MCT.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Function Tests; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Carcinoma; Child; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Middle Aged; Pheochromocytoma; Thyroid Neoplasms

A 31 years old man with an adrenocortical carcinoma was studied. Clinically he had a bilateral and recidiving gynecomastia and showed high urinary oestrogens, 17 cetosteroids, tetra-hydro-desoxy-cortisol and pregnandiol excretion with normal cortisol production. A partial increase on ACTH, no suppression on dexamethasone and no variation on HCG administration were observed. The surgical resection of the tumor normalized this urinary excretion. The serum dehydro-epiandrosterone (DHEA) and sulfate (DHEAS), oestrone, oestradiol, androstenedione (A) levels were greatly elevated. No variations of the cortisol, A, DHEA and DHEAS was noted after ACTH injection. In vitro the lack of ACTH's action was related to an anomaly of ACTH receptor with normal protein kinase activity.

Topics: 17-Ketosteroids; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Adult; Androstenedione; Carcinoma; Chorionic Gonadotropin; Dehydroepiandrosterone; Dexamethasone; Estrogens; Feminization; Humans; Hydrocortisone; Male; Pregnanediol; Tetrahydrocortisol

Topics: 17-Ketosteroids; Adrenal Cortex Neoplasms; Adult; Carcinoma; Female; Humans; Lung Neoplasms; Neoplasm Metastasis; Pleural Effusion

Seven patients with Cushing's syndrome were treated with trilostane (WIN 24,540) 4 alpha,5-epoxy-17 beta-hydroxy-3-oxo-5 alpha-androstane-2 alpha-carbonitrile), an inhibitor of adrenal steroid biosynthesis. Trilostane treatment reduced steroid biosynthesis and it also improved biochemical manifestations of the disease in all of the patients treated. The average cortisol secretory rate decreased significantly with treatment, from 47.1 to 23.4 mg/24 h (P less than 0.005), and urinary 17-hydroxycorticosteroids decreased from 15.7 to 8.7 mg/24 h (P less than 0.01). Urinary free cortisol excretion decreased from 277 to 88 microgram/24 h (P less than 0.01), and 0800 h plasma cortisol levels declined from 25.0 to 12.0 microgram/dl (P less than 0.05). Conversely, dehydroepiandrosterone sulfate excretion in urine increased from 1.3 to 5.8 mg/24 h (P less than 0.0025) and in plasma increased from 162 mg/24 h (P less than 0.025). Plasma and urinary free dehydroepiandrosterone increased 2-fold. Urinary 17-ketosteroid excretion increased from 18 to 43 mg/24 h (P less than 0.001). A significant reduction in urinary excretion of tetrahydroaldosterone, tetrahydrodeoxycorticosterone, and 18-hydroxytetrahydrodeoxycorticosterone was observed with treatment. Inhibition of steroid biosynthesis was accompanied by a 2-fold increase in PRA and no change in serum cholesterol levels. Mean arterial blood pressure decreased with treatment from 109 to 97 mm Hg (P less than 0.005), and fasting blood sugar decreased from 117 to 98 mg/dl (P less than 0.005), accompanied by rise in plasma potassium levels from 3.8 to 4.3 milliequivalents/liter (P less than 0.025). Two patients on long term therapy also showed an improvement in clinical features of their disease. There were no significant treatment-related carcinoma, simultaneously producing both an excessive amount of cortisol and ACTH, is described. It is concluded that trilostane is an effective inhibitor of 3 beta-hydroxysteroid dehydrogenase enzyme system in human adrenal gland; it inhibits biosynthesis of cortisol and it is useful in the treatment of Cushing's syndrome.

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Adult; Blood Pressure; Carcinoma; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Dihydrotestosterone; Female; Humans; Hydrocortisone; Kinetics; Male; Middle Aged; Mineralocorticoids; Potassium; Renin

The case of a young boy who had Cushing's syndrome and severe hypertension in association with metastatic adrenal carcinoma is described. Marked elevation of the mineralocorticoid 11-deoxycorticosterone was demonstrated in the plasma. 11-Deoxycortisol, 17alpha-hydroxyprogesterone, and urinary tetrahydro-11-deoxycortisol and pregnanetriol were also elevated. Aldosterone excretion was low. The data implicate defective 11beta hydroxylation and suggest that excessive 11-deoxycorticosterone production may have been responsible for the hypertension.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Aldosterone; Carcinoma; Child; Cortodoxone; Desoxycorticosterone; Humans; Hydrocortisone; Hydroxyprogesterones; Hypertension; Male; Pregnanetriol

The estrogen receptor was assayed, using the 2,000g supernatant and dextran-coated charcoal method, in 243 tissue samples from human breast cancer, benign breast diseases, macroscopically normal breast tissues, normal uterine myometrium, and uterine myoma. The estrogen receptor was found to be positive in 52.1% of 98 primary breast cancer and in 54.1% of 24 metastatic tumors. The receptor in the breast cancer was found to be similar to that in normal uterine myometrium in the binding character; that is, the dissociation constant of 10(-9) approximately 10(-11) M and number of binding sites of 0 approximately 2,800 fmol/mg protein. There was no correlation between the presence of the receptor and some clinical factors such as menopausal status, age of the patient, urinary 17-ketosteroid excretion, clinical stage of cancer, tumor size, positive or negative axillary lymph node metastasis, histological type, metastatic site of the cancer, or disease-free interval. The estrogen receptor appeared to be retained by metastasis of cancer, and this may lead to the use of the receptor assay with mastectomy specimens for the prediction of response to hormonal therapy in future recurrence of malignancy. Furthermore, it may be possible by this assay to select patients suitable for adjuvant therapy with hormones at the time of mastectomy. A good correlation was found between the presence of the receptor and response to the major endocrine ablation therapy in patients with advanced or metastatic breast cancer. When the receptor was negative in the cancer tissue, the change of response to the endocrine therapy was minimum. On the other hand, if the cancer contained the receptor, approximately 60% of the patients with metastatic or advanced breast cancer responded well to the major endocrine ablation therapy. Thus, the estrogen receptor of breast cancer in Japanese patients appears to bear a close resemblance to that reported in Western patients in its incidence and the correlation to some biological characteristics of the cancer.

Topics: 17-Ketosteroids; Adenocarcinoma, Scirrhous; Adrenalectomy; Breast; Breast Neoplasms; Carcinoma; Castration; Female; Humans; Leiomyoma; Menopause; Menstruation; Myometrium; Neoplasm Metastasis; Receptors, Estrogen; Uterine Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Carcinoma; Cushing Syndrome; Dexamethasone; Female; Humans; Metyrapone; Phlebography; Retropneumoperitoneum

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Neoplasms; Adult; Amenorrhea; Androgens; Androstenedione; Carcinoma; Chorionic Gonadotropin; Clomiphene; Dexamethasone; Estrogens; Ethinyl Estradiol; Female; Hirsutism; Humans; Hydrocortisone; Ovarian Cysts; Ovarian Neoplasms; Pregnancy; Sertoli-Leydig Cell Tumor; Testosterone; Virilism

Serum acid phosphatase activity, urinary total cholesterol, and ratio of deoxy to oxy urinary 17-ketosteroids were measured in a group of 42 patients with prostatic carcinoma and in a group of 14 age-matched normal healthy individuals. Our purpose was to evaluate whether or not the simultaneous determinations of these tests would increase the rate of detection obtained by the single assay alone. The results of single assay revealed for the following detection rate: 67 per cent (28 of 42 patients) for serum acid phosphatase, 62 per cent for urinary total cholesterol, and 22 per cent for ratio of 17-ketosteroids. A significant increase of detection rate was observed when simultaneous determinations of two assays were performed; 86 per cent for serum acid phosphatase activity and total urinary cholesterol; 74 per cent for serum acid phosphatase and ratio of 17-ketosteroids; and 74 per cent for total urinary cholesterol and ratio of 17-ketosteroids. A detection rate of 88 per cent (37 of 42 patients) was obtained as all three assays were analyzed, though it was not significantly different from a ratio of 86 per cent for simultaneous assays of acid phosphatase and total cholesterol. It was concluded that simultaneous determinations of serum acid phosphatase activity, urinary total cholesterol, and androgens are of values in diagnosis for patients with prostatic neoplasia.

Topics: 17-Ketosteroids; Acid Phosphatase; Aged; Androgens; Carcinoma; Cholesterol; Humans; Ketosteroids; Male; Middle Aged; Prostatic Neoplasms

Topics: 11-Hydroxycorticosteroids; 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adult; Androstenedione; Androsterone; Carcinoma; Chromatography, Ion Exchange; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Female; Humans; Hyperplasia; Male; Middle Aged; Sex Factors; Tetrahydrocortisol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Carcinoma; Child, Preschool; Estrogens; Humans; Male; Puberty, Precocious; Testosterone

Topics: 17-Ketosteroids; Aged; Carcinoma; Castration; Estrogens; Female; Fumarate Hydratase; Glucosephosphate Dehydrogenase; Glyceraldehyde-3-Phosphate Dehydrogenases; Hexokinase; Humans; Isocitrate Dehydrogenase; L-Lactate Dehydrogenase; Malate Dehydrogenase; Menopause; Microscopy, Electron; Middle Aged; Ovary; Phosphoglycerate Kinase; Phosphopyruvate Hydratase; Uterine Cervical Neoplasms; Uterine Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Carcinoma; Chlormadinone Acetate; Estrogens; Evaluation Studies as Topic; Humans; Male; Medroxyprogesterone; Megestrol; Progesterone; Prostatic Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acetates; Adenoma; Adrenal Gland Neoplasms; Androstenedione; Carbon Isotopes; Carcinoma; Cholesterol; Chromatography, Paper; Chromatography, Thin Layer; Dehydroepiandrosterone; Estradiol; Estriol; Estrogens; Estrone; Female; Humans; In Vitro Techniques; Methods; Middle Aged; Tritium

Topics: 17-Ketosteroids; Aged; Alkaline Phosphatase; Androgen Antagonists; Carcinoma; Cyproterone; Humans; Hydroxysteroids; Male; Middle Aged; Pain; Pregnadienes; Prostatic Neoplasms

Topics: 17-Ketosteroids; Aged; Androstanes; Carbon Isotopes; Carcinoma; Choriocarcinoma; Endometrium; Estradiol; Estriol; Estrone; Female; Humans; Middle Aged; Pregnancy; Tritium; Uterine Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Alkaline Phosphatase; Androgens; Autopsy; Carcinoma; Carcinoma, Bronchogenic; Chorionic Gonadotropin; Estrogens; Growth Hormone; Gynecomastia; Hormones, Ectopic; Humans; Immunoassay; Lung Neoplasms; Male; Neoplasm Metastasis; Placental Hormones; Placental Lactogen; Thyroid Function Tests

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Carcinoma; Cushing Syndrome; Humans; Male; Thyroid Neoplasms; Thyroidectomy

Topics: 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenal Insufficiency; Adult; Aged; Alcohols; Amenorrhea; Androsterone; Carcinoma; Child, Preschool; Chromatography, Gas; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Female; Genital Diseases, Male; Hirsutism; Humans; Hyperplasia; Hyperthyroidism; Hypospadias; Infant; Infertility, Male; Klinefelter Syndrome; Lactation Disorders; Male; Middle Aged; Polycystic Ovary Syndrome; Pregnancy; Pregnanetriol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Amenorrhea; Carcinoma; Creatinine; Estrogens; Female; Hirsutism; Humans; Hydrocortisone; Hyperplasia; Neoplasm Metastasis; Pituitary-Adrenal System; Pregnanetriol; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Abdominal Neoplasms; Acetates; Adrenal Gland Neoplasms; Adrenal Insufficiency; Adrenalectomy; Adrenocorticotropic Hormone; Carcinoma; Child; Cortisone; Dexamethasone; Dichlorodiphenyldichloroethane; Female; Fluorine; Humans; Hydrocortisone; Lung Neoplasms; Metabolism; Neoplasm Metastasis; Prednisolone; Radiography; Splenectomy; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adult; Alcohols; Androstanes; Carbon Isotopes; Carcinoma; Chromatography, Gas; Dichlorodiphenyldichloroethane; Estradiol; Estriol; Estrone; Humans; Ketosteroids; Mass Spectrometry; Pregnanes; Pregnanetriol; Steroids; Sulfuric Acids; Tritium

Topics: 17-Ketosteroids; Adult; Aged; Alanine Transaminase; Albuminuria; Aspartate Aminotransferases; Blood Cell Count; Blood Sedimentation; Calcium; Carcinoma; Cyclophosphamide; Diarrhea; Endometriosis; Feeding and Eating Disorders; Female; Genital Neoplasms, Female; Hematocrit; Hematopoiesis; Hemoglobins; Humans; L-Lactate Dehydrogenase; Liver Function Tests; Middle Aged; Mucoproteins; Ovarian Neoplasms; Time Factors; Uterine Cervical Neoplasms; Vulvar Neoplasms

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Hyperplasia, Congenital; Androgens; Carcinoma; Child, Preschool; Dichlorodiphenyldichloroethane; Female; Hirsutism; Humans; Liver Neoplasms; Lung Neoplasms; Neoplasm Metastasis; Neoplasm Recurrence, Local; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Aged; Carcinoma; Dehydroepiandrosterone; Endometrium; Estriol; Estrogens; Estrone; Female; Humans; Menopause; Vaginal Smears

Topics: 17-Ketosteroids; Adolescent; Adult; Aged; Androsterone; Breast Neoplasms; Carbon Isotopes; Carcinoma; Child; Child, Preschool; Chromatography; Dehydroepiandrosterone; Endocrine System Diseases; Etiocholanolone; Female; Humans; Infant; Male; Methods; Middle Aged; Polycystic Ovary Syndrome; Prostatic Neoplasms; Testosterone; Tritium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Calcitonin; Carcinoma; Creatinine; Cushing Syndrome; Dexamethasone; Female; Hormones, Ectopic; Humans; Hydrocortisone; Middle Aged; Parathyroid Hormone; Radioimmunoassay; Thyroid Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adult; Blood Glucose; Carcinoma; Creatinine; Dexamethasone; Epinephrine; Female; Glucagon; Glucose; Glucose Tolerance Test; Humans; Hypoglycemia; Insulin; Lactates

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adult; Carcinoma; Dichlorodiphenyldichloroethane; Humans; Male

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenalectomy; Adult; Carcinoma; Cushing Syndrome; Diagnosis, Differential; Humans; Hyperplasia; Precancerous Conditions

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Aged; Carcinoma; Humans; Hyperaldosteronism; Male; Renin

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Glands; Adult; Angiography; Carcinoma; Child; Cushing Syndrome; Female; Humans; Hypertension; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Pheochromocytoma; Renal Artery; Surgical Procedures, Operative; Thymoma; Urography; Vena Cava, Inferior

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Androsterone; Aniline Compounds; Carcinoma; Cushing Syndrome; Etiocholanolone; Female; Humans; Middle Aged; Neoplasm Metastasis; Pyridones; Retroperitoneal Neoplasms; Steroids

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Carcinoma; Child; Chromatography; Female; Humans; Pregnanetriol; Pregnenolone; Spectrum Analysis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Abnormalities, Multiple; Adenoma; Adrenal Gland Neoplasms; Carcinoma; Child, Preschool; Cushing Syndrome; Dexamethasone; Female; Growth; Humans; Hydrocortisone; Hypertrophy; Infant; Infant, Newborn; Insulin; Male; Metyrapone; Pituitary-Adrenal Function Tests; Radiography; Sepsis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adult; Antineoplastic Agents; Carcinoma; Cortisone; Dichlorodiphenyldichloroethane; Estrogens; Female; Gonadotropins; Humans; Hydrocortisone; Lung Neoplasms; Neoplasm Metastasis; Pregnanediol; Pregnanetriol

Topics: 17-Ketosteroids; Adenocarcinoma; Adult; Androgens; Carcinoma; Chorionic Gonadotropin; Dexamethasone; Diagnosis, Differential; Endometrial Hyperplasia; Endometrium; Estrogens; Female; Humans; Ovary; Polycystic Ovary Syndrome; Progestins; Uterine Neoplasms

Topics: 17-Ketosteroids; Adenofibroma; Adrenalectomy; Adult; Aged; Androstanes; Breast Neoplasms; Carcinoma; Chemistry, Clinical; Dehydroepiandrosterone; Estriol; Female; Humans; Menopause; Middle Aged; Steroids

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acne Vulgaris; Adenoma; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Carcinoma; Child; Child, Preschool; Dehydroepiandrosterone; Female; Hirsutism; Humans; Infant; Lung Neoplasms; Male; Neoplasm Metastasis; Radiography; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Carcinoma; Cushing Syndrome; Dexamethasone; Female; Hormones, Ectopic; Humans; Lymphatic Metastasis; Male; Metyrapone; Pheochromocytoma; Thyroid Neoplasms; Thyroidectomy

Topics: 17-Ketosteroids; Carcinoma; Chromatography, Paper; Female; Humans; Middle Aged; Ovarian Neoplasms; Sulfates; Testosterone; Virilism

Topics: 17-Ketosteroids; Adult; Androstanes; Carcinoma; Chromatography, Gas; Female; Humans; Ovarian Neoplasms; Testosterone; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Carcinoma; Chorionic Gonadotropin; Estrogens; Feminization; Gonadotropins, Pituitary; Humans; Male; Middle Aged; Pregnancy Tests

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenocarcinoma; Adrenocortical Hyperfunction; Aged; Carcinoma; Carcinoma, Bronchogenic; Carcinoma, Squamous Cell; Estrogens; Female; Hormones; Humans; Hydrocortisone; Lung Neoplasms; Male; Middle Aged; Pituitary-Adrenal Function Tests; Sex Factors; Steroids

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Glands; Adrenalectomy; Breast Neoplasms; Carcinoma; Female; Humans; Middle Aged; Organ Size

Topics: 17-Ketosteroids; Adrenal Glands; Animals; Carcinoma; Chlormadinone Acetate; Estrogens; Gonadotropins, Pituitary; Gonads; Hydroxyprogesterones; Luteinizing Hormone; Male; Prostatic Hyperplasia; Prostatic Neoplasms; Testosterone

Topics: 17-Ketosteroids; Adenocarcinoma; Adult; Age Factors; Aged; Breast Neoplasms; Carcinoma; Epithelium; Estrogens; Gynecomastia; Humans; Japan; Liver Function Tests; Male; Middle Aged; Mitosis; Prostatic Hyperplasia; Prostatic Neoplasms

Topics: 17-Ketosteroids; Adolescent; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adult; Androstanes; Androsterone; Carcinoma; Chemistry, Clinical; Chromatography, Thin Layer; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Female; Humans; Kidney Neoplasms; Lung Neoplasms; Male; Methods; Ovarian Diseases; Testicular Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Aminoglutethimide; Animals; Anticoagulants; Carcinoma; Cushing Syndrome; Female; Humans; Hydrocortisone; Metyrapone; Middle Aged; Pituitary-Adrenal Function Tests; Secretory Rate

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenocarcinoma; Adenocarcinoma, Mucinous; Adenocarcinoma, Scirrhous; Adrenal Glands; Adult; Aged; Carcinoma; Endopeptidases; Female; Humans; Male; Middle Aged; Pituitary-Adrenal Function Tests; Stomach; Stomach Neoplasms

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adrenocortical Hyperfunction; Adult; Carcinoma; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypertension; Intestinal Polyps; Male; Pheochromocytoma

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Bicarbonates; Blood Glucose; Bronchial Neoplasms; Carcinoma; Corticosterone; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Middle Aged; Pituitary Function Tests; Pituitary-Adrenal Function Tests; Potassium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Gland Neoplasms; Adult; Aged; Antineoplastic Agents; Black or African American; Carcinoma; Child; Child, Preschool; Cushing Syndrome; Dichlorodiphenyldichloroethane; Female; Humans; Infant; Male; Middle Aged; Neoplasm Metastasis; Sex; White People

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenalectomy; Carcinoma; Diagnosis, Differential; Neoplasms; Pathology; Radiography; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Alkalosis; Carcinoma; Carcinoma, Squamous Cell; Esophageal Neoplasms; Humans; Hypokalemia; Liver Neoplasms; Neoplasm Metastasis; Pathology; Pituitary-Adrenal Function Tests

Topics: 17-Ketosteroids; Adenocarcinoma; Androsterone; Biomedical Research; Body Weight; Carcinoma; Carcinoma, Squamous Cell; Emphysema; Etiocholanolone; Fluids and Secretions; Humans; Liver Function Tests; Lung Neoplasms; Metabolism; Pregnanediol; Pulmonary Emphysema; Urine

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Hormones; Carcinoma; Estradiol; Estradiol Congeners; Estriol; Estrone; Geriatrics; Humans; Male; Prostatic Neoplasms; Stilbenes; Urine

Topics: 17-Ketosteroids; Acid-Base Equilibrium; Adrenocortical Hyperfunction; Alkalosis; Carcinoma; Electrocardiography; Humans; Hypokalemia; Lung Neoplasms; Lymphatic Metastasis; Potassium; Sodium; Urine

Topics: 17-Ketosteroids; Adolescent; Blood Chemical Analysis; Breast; Breast Neoplasms; Carcinoma; Female; Humans; Neoplasms; Ovarian Neoplasms; Uterine Neoplasms

Topics: 17-Ketosteroids; Adolescent; Breast; Carcinoma; Castration; Child; Chorionic Gonadotropin; Dysgerminoma; Estradiol; Estriol; Estrogens; Estrone; Female; Gonadotropins; Gonadotropins, Pituitary; Growth; Humans; Hysterectomy; Menarche; Menstruation; Neoplasms; Ovarian Neoplasms; Ovary; Pituitary Gland; Pituitary-Adrenal Function Tests; Puberty; Sexual Maturation; Urine

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Androgens; Androsterone; Carcinoma; Carcinoma, Bronchogenic; Chromatography; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Geriatrics; Humans; Kidney Function Tests; Neoplasms

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Carcinoma; Carcinoma, Squamous Cell; Estradiol; Estriol; Estrogens; Estrone; Female; Humans; Neoplasms; Radium; Urine; Uterine Cervical Neoplasms

Topics: 17-Ketosteroids; Carcinoma; Cortisone; Hormones; Humans; Lung Neoplasms; Male; Prostatic Neoplasms

Topics: 17-Ketosteroids; Animals; Carcinoma; Choriocarcinoma; Chromatography; Female; Humans; Hydatidiform Mole; Moles; Neoplasms, Glandular and Epithelial; Pregnancy

Topics: 17-Ketosteroids; Body Fluids; Carcinoma; Humans; Radiation Effects

Topics: 17-Ketosteroids; Breast; Breast Neoplasms; Carcinoma; Humans; Steroids

Topics: 17-Ketosteroids; Carcinoma; Female; Genitalia; Genitalia, Female; Humans; Neoplasms; Prognosis; Radiotherapy

Topics: 17-Ketosteroids; Carcinoma; Genitalia; Genitalia, Female; Neoplasms; Steroids

Topics: 17-Ketosteroids; Carcinoma; Genitalia; Genitalia, Female; Neoplasms; Steroids; Testosterone

Topics: 17-Ketosteroids; Androgens; Biological Transport; Carcinoma; Female; Humans; Radium; Uterus; Vagina