Pregnancy in women with a hormone producing adrenal carcinoma is a rare occurrence because the patients have usually an amenorrhea or an anovulatory cyclus. Only on two of five cases reported in the literature have biochemical studies been performed (1-4). The present report is concerned with clinical features, plasma and urinary steroid patterns of a pregnant patient with ectopic adrenal carcinoma.Case report: The patient was a 26 year old woman who was referred to the Endo~ine Dept. of our hospital in June 1~67. An elevated value of urinary 17-ketosteroids (159 mg/day) hud been found in another laboratory 6 monthsprior to hospitalization. On admission she had hypertrichosis of the face and extremities, but no acne or striue were present, breast development was normal. She had oligomenorrhea of approximately 7 years duration with the last menstrual period being in March 1967. There were no abnormal laboratory findings except low serum potassiulIl level (3,4 mEq/I).The urinary immunological HCG test was positive und gynecological examination revealed pregnancy 3 rd to 4 th montn.Adrenocortical function studies: Preoperatively the values of 11-hydroxycorticosteroids in plasma, measured fluorimetrically, were within the normal range (19 pg%) which after administration of ACTH (Synacthen 0,25 mg i.m.) rose to 49 p.ft'/o 30 min post injection. Values of 24 hr urinary 17-hydroxycorticosteroids (3,0 -5,4 mg), tetrahydrocortisol (0,48 mg/ day), tetrahydrocortisone (1,09 mg/day) and tetrahydrocorticosterone (0,42 mg/day) were within the normal limits of our laborator~ The cortisol secretion rate was 23,7 mg/day and corticosterone secretion rate 7,2 mg/day measured by an isotope dilution technique. Urinary 17-ketosteroids were extremely elevated (152-230 mg/day in 24 hr urine specimen). No significant decrease in 17-ketosteroid excretion resulted after administration of Dexamethasone (212 mg/ day after 9 mg Dexamethasone given orally in 3 days). Dehydroepiandrosterone, etiocholanolone and androsterone were measured separately in urine. One tenth of 24 hr urine collection was incubated with 1000 units per ml of ß-glucuronidase for 48 hr at 57 0 C and extracted twice with ether. After addition of radioactive tracers, the steroids were separated und purified by chromatography in several systems. After their conversion into trimethylsilylethers they were further analyzed by gas chromatography on glass column, packed with 1% XE 60 on Gas Chrom P using an argon ionization detector. The amount of steroids was calculated from the peak areas ( fig. 1). Testosterone was isolated using the me-
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