Major hyperestrogenism in a feminizing adrenocortical adenoma despite a moderate overexpression of the aromatase enzyme.

• Abstract: A 30-year-old male was referred for the rapid development of gynecomastia, and dramatic hyperestrogenemia was assessed: plasma estrone, estradiol but also cortisol were not suppressed by high-dose dexamethasone, while gonadotropin pulsatility was completely abolished. A 60-mm right adrenal tumor was evidenced on computed tomography-scan, and the patient underwent adrenalectomy. The tumor was found to express a moderate increase in aromatase activity compared with adjacent non-neoplastic adrenal tissue. Quantitative RT-PCR also showed a weak and non-significant increase in total aromatase mRNA in the tumor compared with normal adrenal tissue. Aromatase transcripts were mainly promoter PII-derived, but different patterns of aromatase minor transcripts were found: promoter I.3- and I.6-derived transcripts were identified in the tumor, while only promoter I.4-derived transcripts were found in normal adrenal. This case report demonstrates that a sharp aromatase overexpression is not a prerequisite for clinical and biochemical hyperestrogenism, and further characterizes the aromatase promoter utilization in this feminizing adrenocortical tumor and in the normal adrenal cortex.
• Authors: Helene Bouraïma, Barbara Lireux, Hervé Mittre, Annie Benhaim, Michel Herrou, Jacques Mahoudeau, Francoise Guillon-Metz, Marie-Laure Kottler, Yves Reznik (Affiliation: EA 2608-USC INRA, Université de Caen, 14032 Caen Cedex, France.)
• Journal: European journal of endocrinology / European Federation of Endocrine Societies (Eur J Endocrinol) Vol. 148 Issue 4 Pg. 457-61 (Apr 2003) ISSN: 0804-4643 [Print] England
• PMID: 12656667 (Publication Type: Case Reports, Journal Article)

Chemical References

• Estrogens
• RNA, Messenger
• Estradiol
• Estrone
• Testosterone
• Androstenedione
• 17-alpha-Hydroxyprogesterone
• Aromatase

Topics

• 17-alpha-Hydroxyprogesterone (analysis)
• Adenoma (complications, enzymology, surgery)
• Adrenal Cortex (chemistry)
• Adrenal Cortex Neoplasms (complications, enzymology, surgery)
• Adrenalectomy
• Adult
• Androstenedione (analysis)
• Aromatase (genetics, metabolism)
• Estradiol (analysis)
• Estrogens (blood)
• Estrone (analysis)
• Feminization (etiology)
• Gene Expression
• Gynecomastia (etiology)
• Humans
• Male
• RNA, Messenger (analysis)
• Reverse Transcriptase Polymerase Chain Reaction
• Testosterone (analysis)