1. Major hyperestrogenism in a feminizing adrenocortical adenoma despite a moderate overexpression of the aromatase enzyme
- Author
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Jacques Mahoudeau, Helene Bouraïma, Barbara Lireux, Marie-Laure Kottler, Annie Benhaim, Francoise Guillon-Metz, Michel Herrou, Hervé Mittre, Yves Reznik, Département de Physiologie Animale (PA), Institut National de la Recherche Agronomique (INRA), Œstrogènes, reproduction, cancer (OeReCa), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), and ProdInra, Migration
- Subjects
Male ,[SDV]Life Sciences [q-bio] ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gene Expression ,Adrenocortical adenoma ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,[SDV.BC.IC]Life Sciences [q-bio]/Cellular Biology/Cell Behavior [q-bio.CB] ,Testosterone ,Aromatase ,ComputingMilieux_MISCELLANEOUS ,Estradiol ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,Adrenal cortex ,17-alpha-Hydroxyprogesterone ,Adrenalectomy ,General Medicine ,[SDV] Life Sciences [q-bio] ,medicine.anatomical_structure ,Gynecomastia ,030220 oncology & carcinogenesis ,medicine.symptom ,Adenoma ,Adult ,medicine.medical_specialty ,Estrone ,030209 endocrinology & metabolism ,[INFO] Computer Science [cs] ,Hyperestrogenism ,[SDV.BDLR.RS]Life Sciences [q-bio]/Reproductive Biology/Sexual reproduction ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Feminization ,[INFO]Computer Science [cs] ,RNA, Messenger ,SURRENALE ,Androstenedione ,[SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology ,Estrogens ,medicine.disease ,Adrenal Cortex Neoplasms ,chemistry ,Adrenal Cortex ,biology.protein - Abstract
International audience; 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.
- Published
- 2003
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