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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rapidly increasing testosterone levels were observed in a patient presenting with sudden onset of virilization. Exploratory laparotomy revealed a placental site trophoblastic tumor in the uterus. Wedge biopsies of the ovaries showed extensive luteinization of the ovarian stroma in both ovaries. Concentrations of testosterone, dihydrotestosterone, and androstenedione were markedly increased in the ovarian vein serum, indicating ovaries as the source of these steroids. The serum concentration of hCG was 69 mIU/mL. Pulsatile secretion of LH persisted in spite of elevated hCG levels. Follicle-stimulating hormone levels were low or undetectable. Elevated hCG levels and low FSH levels resulted in a hormonal environment similar to that seen in polycystic ovary disease (high LH to FSH ratio), resulting in extensive stromal luteinization. Decline in hCG levels after removal of the tumor resulted in the return of androgen levels to normal.
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PMID:Hyperthecosis of the ovaries in a woman with a placental site trophoblastic tumor. 217 Aug 89

A 15-yr-old, apparently male, patient presented with a 2-yr history of gynecomastia and poor genital development. A normally formed, but small, penis with a phallic urethra was present, and testes were impalpable. The karyotype was 46,XX, and at laparotomy a uterus, Fallopian tubes, and ovaries were found, but there was no testicular tissue. The mother had had regular periods ever since menarche at 14 yr. She had complained of hirsutism since the birth of the child, and on examination 15 yr later had marked clitoromegaly. Serum androgens were elevated: testosterone, 4.5 nmol/L (normal, 0.5-3); dehydroepiandrosterone sulfate, 18 mumol/L (normal, 3-12); and androstenedione, 35 nmol/L (normal, 3-8). All failed to suppress with dexamethasone. Abdominal computed tomographic scan revealed a 9 X 6-cm mass in the position of the left adrenal gland. This was removed at laparotomy and found to be an adrenocortical tumor. Postoperatively, the androgens returned to normal. Virilization of a female fetus due to androgens secreted by a maternal adrenal tumor has only been described three times previously, and the presentation has never been delayed so long.
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PMID:Female pseudohermaphroditism due to a maternal adrenocortical tumor. 218 56

A two year old girl with symptoms of virilization was investigated and an adrenal gland tumor with morphological sings of malignancy was diagnosed. After surgery, irradiation and chemotherapy, a complete recovery was observed. The authors point out the diagnostical difficulties in similar cases. Our observation seems to confirm earlier suggestions, that in cases with predominant androgen activity the better prognosis is expected.
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PMID:[Clinical and morphological picture of adrenal gland carcinoma with characteristics of early embryonal development]. 221 Apr 83

Adrenocortical carcinoma (ACC), a very rare tumor in children in the United States, is apparently more common among Brazilian children. We reviewed the medical records of 40 children whose disease was diagnosed between 1966 and 1987. There were 12 boys and 28 girls; their median age was 3.9 years (range, 1 day to 15.7 years). Virilization was the most common clinical sign (37 of 40); other signs included abdominal mass, deepened voice, plethora, hypertension, seizures (seven patients) and, rarely, weight loss (two patients). The median time between first signs or symptoms and diagnosis was 1.4 years (range, 3 days to 5 years). Four of 33 tumors were classified as benign according to the Weiss, van Slooten, or Hough systems (tumor tissue was unavailable for seven patients). Tumors were completely resected in 26 of 38 patients; of those, 17 are in continuous complete remission, five relapsed, and four have been lost to follow-up. One patient, who had local recurrence, has been in a third complete remission for 18+ months after tumor resection and chemotherapy (cisplatin and etoposide). Of the remaining 14 patients, 11 died of progressive disease, the diagnosis was confirmed at autopsy in two, and one has been lost to follow-up. Univariate analysis disclosed that age greater than or equal to 3.5 years at diagnosis, interval of greater than or equal to 6 months between first symptoms and diagnosis, tumor weight greater than 100 g, tumor size greater than 200 cm3, and high levels of urinary 17-ketosteroids (17-KS) and 17-hydroxycorticosteroids (17-OH) were associated with an unfavorable outcome. Multivariate analysis disclosed that only a tumor size greater than 200 cm3 independently identifies those patients with an unfavorable prognosis. Among the variables known before surgery, age, and the interval between first symptoms and diagnosis were important predictors of outcome. Our data suggest that some children with ACC and certain clinical characteristics are at high risk of primary treatment failure and, therefore, are good candidates for investigational adjuvant therapy.
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PMID:Adrenocortical carcinoma in children: a study of 40 cases. 229 12

A 3-year-old boy who presented with signs of virilization had a Leydig cell tumor of the left testis that could not be detected by physical examination or by high resolution ultrasonography. His very small tumor was demonstrated by magnetic resonance imaging. The implications of adding this sensitive method of imaging to the evaluation of prepubertal virilization of presumed testicular etiology are discussed.
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PMID:Viralization due to Leydig cell tumor diagnosis by magnetic resonance imaging. Case management report. 237

A case of an ovarian, poorly differentiated, Sertoli-Leydig cell tumor in a 55-year-old woman is reported. The patient showed no virilization, but did show elevated serum alpha-fetoprotein (AFP) levels. The tumor, measuring 70 x 45 x 50 mm, consisted mainly of a diffuse proliferation of spindle cells. Among this proliferation, some tubules of Sertoli cells and groups of leydig cells were found. Immunoperoxidase studies, using anti-AFP, localized the AFP in the leydig cells.
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PMID:[An alpha-fetoprotein producing Sertoli-Leydig cell tumor--a case report]. 246 36

An 18-year-old girl with virilization and an elevated level of serum alpha-fetoprotein (AFP) was found to have a Sertoli-Leydig cell tumor (SLCT) of the ovary. The tumor had a heterologous element of gastrointestinal type epithelium, retiform pattern, and multilocular cysts, many of which were lined by Sertoli-like cells. Alpha-fetoprotein was detected immunohistochemically in cells with the histologic appearance of Sertoli cells, and testosterone was detected in the Leydig cells. Results of lectin affinity chromatography indicated that AFP produced by this tumor was different from the AFP to be found in the liver.
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PMID:Ovarian Sertoli-Leydig cell tumor with elevated serum alpha-fetoprotein. 246 33

A 21-year-old white woman presented with virilization, hirsutism, and acne of 1.5 years' duration. Endocrine testing demonstrated complete suppression of serum testosterone, from 5.3 to 0.6 ng/mL, and serum androstenedione, from 4.7 to 1.7 ng/mL, after oral administration of 50 micrograms of mestranol and 1 mg of norethindrone for 21 days. No suppression of either steroid was produced by dexamethasone, whereas serum dehydroepiandrosterone sulfate was suppressed from 5.2 to 1.9 micrograms/mL. A left salpingo-oophorectomy was performed for a 3 x 4-cm Sertoli-Leydig cell tumor of intermediate differentiation. Intraoperative studies demonstrated that the tumor secreted testosterone, androstenedione, 17 alpha-hydroxyprogesterone, and estradiol, but not dehydroepiandrosterone sulfate. These findings support the thesis that hormonal manipulation tests cannot differentiate between adrenal and ovarian virilizing tumors. Nor does the oral contraceptive suppression of testosterone secretion exclude an ovarian malignancy. The patient remains free of recurrence after 7 years.
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PMID:Diagnosis and resection of an oral contraceptive-suppressible Sertoli-Leydig cell tumor with preservation of fertility and a 7-year follow-up. 252 30

A 78-year-old woman had a 3-year history of severe virilization caused by a lipoid cell ovarian tumor localized by pelvic ultrasound examination and NP-59 scan. Steroid secretion was evaluated by the following: 1) peripheral plasma levels before and after hormonal stimulation with ACTH or hCG, 2) venous catheterization and measurement of steroid levels in the left and right ovarian veins during surgery, 3) measurements of enzymatic activities in the tumor tissue compared with those in normal ovarian tissue, and 4) steroid secretion studies in vitro of the tumor tissue, surrounding tissue, and contralateral ovarian tissue. The tumor tissue secreted both delta 5 and delta 4 androgens, including dehydroepiandrosterone sulfate. Dehydroepiandrosterone sulfate was also secreted by the surrounding and contralateral ovarian tissue.
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PMID:Steroid secretion by a virilizing lipoid cell ovarian tumor: origins of dehydroepiandrosterone sulfate. 252 48

Fetal virilization induced by a maternal adrenal tumor is extremely rare. We report a case of a maternal adrenocortical tumor with Cushing's syndrome causing fetal virilization.
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PMID:A maternal functioning adrenocortical adenoma causing fetal female pseudohermaphroditism. 254 73


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