STEROID EXCRETION AND BIOSYNTHESIS, WITH SPECIAL REFERENCE TO ANDROST-16-ENES, IN A WOMAN WITH A VIRILISING ADRENOCORTICAL CARCINOMA

Abstract

ABSTRACT The level of 3α-hydroxy-5α-androst-16-ene (Δ16-androstenol) excreted as glucuronide in the urine of a woman with virilising adrenal carcinoma was measured by gas-liquid chromatography (GLC) of the free steroid and its chloromethyl dimethyl silyl (CMDS) ether and found to be 1.46 mg/day. On the basis of thin-layer chromatography (TLC) and GLC of free steroid and derivatives, Δ16-androstenol has also been tentatively identified in the urinary sulphate fraction and in peripheral plasma. The values were approx. 0.6 mg/d and 2.8 μg/100 ml respectively. After operation, the amount of urinary Δ16-androstenol (as glucuronide) fell to a low level; none was detected in plasma or in urine (as sulphate). Levels of other steroids in the urine and plasma were consistent with the clinical diagnosis of virilising adrenal carcinoma. After operation, the excretion of most of these steroids had reverted to values which were normal or lower. In vitro, the cancerous adrenal tissue metabolised 4-14C-pregnenolone to 3β-hydroxy-androsta-5,16-diene (0.2 %) and 4-14C-progesterone to a small quantity (< 0.03 %) of androsta-4,16-dien-3-one. No androst-16-enes were formed from radioactive dehydroepiandrosterone (DHA) or testosterone. The formation of other labelled metabolites confirmed studies by earlier workers.