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Steroid secretion by masculinizing and "feminizing" Hilus cell tumors
The Journal of Clinical Endocrinology and Metabolism
|April 1, 1981
Summary
Hilus cell tumors exhibit distinct clinical presentations due to differing steroid secretion. Enzyme activity dictates whether testosterone or androstenedione is predominantly produced, leading to virilism or estrogenic effects.
Area of Science:
- Endocrinology
- Oncology
- Reproductive Medicine
Background:
- Hilus cell tumors are rare ovarian neoplasms.
- These tumors can present with diverse clinical manifestations, including virilism or estrogenic signs.
Observation:
- Two patients with hilus cell tumors were studied, one exhibiting virilism and the other estrogenic signs.
- Steroid secretion was analyzed by measuring hormone gradients and levels before and after surgery.
Findings:
- Both tumors utilized a similar steroidogenic pathway from pregnenolone.
- The patient with virilism predominantly secreted testosterone (T), while the other secreted androstenedione (delta).
- Elevated circulating estrogen levels in the estrogenic patient arose from peripheral aromatization of secreted delta, despite limited tumor aromatase activity.
Implications:
- The 17 beta-dehydrogenase enzyme's activity and redox state determine the predominant secretion of T or delta.
- This enzymatic difference explains the contrasting biological effects observed in patients with hilus cell tumors.
- Understanding these pathways is crucial for diagnosing and managing these rare ovarian neoplasms.