Incidentally discovered adrenocortical adenomas are not fully nonfunctioning: Immunohistochemical and dispersed adrenocortical cell study

Junichi Tobinaga, Tsuneo Imai, Hiroomi Funahashi, Yuji Tanaka, Masaki Wada, Takako Morita, Fumio Yamada, Kyosuke Tsukamura, Mikinao Oiwa, Toyone Kikumori, Hironobu Sasano, Hiroshi Takagi

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

To clarify the precise function of incidentally discovered adrenocortical adenoma, immunohistochemical and dispersed adrenal cell studies were performed. We have recently seen five patients with so called nonfunctioning adrenocortical adenoma. Diurnal variation in plasma cortisol and suppression of plasma cortisol and urine 17 hydroxycorticosteroids in response to dexamethasone administration revealed adrenocortical function within normal limits in all cases, and no signs or symptoms of adrenal steroid hormone excess were evident. Since a high uptake of iodomethyl-norcholesterol was recognized in each adrenal mass, it was supposed that these adrenal tumors produced steroid hormone to a certain extent, and each patient received unilateral adrenalectomy. P450c17, a key enzyme involved in cortisol production, was expressed in the tumor region in all cases in an immunohistochemical study. Upon in vitro steroidogenesis with dispersed adrenal cells in two cases, all steroid hormones measured except for aldosterone (progesterone, 17α-hydroxyprogesterone, pregnenolone, 17α- hydroxypregnenolone, 11-deoxycortisol, cortisol, 11-deoxycorticosterone, corticosterone, 18-hydroxydeoxycorticosterone, dehydroepiandrosterone and androstenedione) were produced in a culture medium. The results indicated that these tumors possessed the capacity for cortisol production, which was in agreement with the results of an iodomethyl-norcholesterol scintigraphy. All patients with mild hypertension or diabetes mellitus had no signs or symptoms of steroid hormone excess, but they could potentially develop a steroid excess syndrome such as Cushing's syndrome in the future.

Original languageEnglish
Pages (from-to)79-86
Number of pages8
Journalendocrine journal
Volume43
Issue number1
DOIs
Publication statusPublished - 1996 Feb

Keywords

  • Adrenal gland
  • Dispersed cell
  • Immunohistochemistry
  • Incidentaloma
  • Nonfunctioning adenoma

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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