17-ketosteroids and Muscle-Weakness

Here we report a case of a renin-producing adrenocortical carcinoma. A 57-year-old woman was referred to our hospital complaining of thirst and generalized muscle weakness. She was diagnosed as being hypertensive and diabetic with associated hypokalemia and she had a hard elastic mass with a diameter of 10 cm on the left side of her neck. An abdominal computed tomography scan revealed a suprarenal mass on the left side (8.5 x 8 x 6.5 cm). Endocrinological examination demonstrated a marked elevation in the patient's serum glucocorticoid and sex steroid hormones as well as plasma renin activity. Histological examination of a sample taken from the neck mass revealed a metastasis from an adrenal carcinoma, which was stained positively with antibodies against cytochrome P450 and renin, establishing the diagnosis of a renin-producing adrenocortical carcinoma. Trilostane was effective in reducing serum cortisol levels, but mitotane was ineffective.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; 3-Hydroxysteroid Dehydrogenases; Adrenal Cortex Neoplasms; Biopsy, Needle; Catecholamines; Cytochrome P-450 Enzyme System; Dihydrotestosterone; Enzyme Inhibitors; Female; Glucocorticoids; Gonadal Steroid Hormones; Humans; Hydrocortisone; Hypertension; Hypokalemia; Middle Aged; Mitotane; Muscle Weakness; Neoplasm Metastasis; Renin; Thirst; Tomography, X-Ray Computed