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Journal of Endocrinological Investigation

, Volume 23, Issue 5, pp 287–294 | Cite as

Comparative analysis of plasma 17-hydroxyprogesterone and cortisol responses to ACTH in patients with various adrenal tumors before and after unilateral adrenalectomy

  • Miklós Tóth
  • K. Rácz
  • V. Adleff
  • I. Varga
  • L. Fütö
  • C. Jakab
  • K. Karlinger
  • R. Kiss
  • E. Gláz
Original Article

Abstract

Patients with non-hyperfunctioning adrenal adenomas often have an increased plasma 17-hydroxyprogesterone response to ACTH stimulation. The effects of adrenal surgery on this abnormality have rarely been investigated. One hundred and sixty-one patients with unilateral adrenal tumors (non-hyperfunctioning adenomas, 78; cortisol-producing adenomas, 8; aldosteroneproducing adenomas, 37; adrenal cysts, 12; pheochromocytomas, 26) were studied. Patients before and after adrenal surgery as well as 60 healthy subjects underwent an ACTH stimulation test using 2 mg synthetic ACTH1-24 (Cortrosyn Depot, Organon). Basal and ACTH-stimulated plasma 17- hydroxyprogesterone and cortisol concentrations are reported. Before adrenal surgery, the basal plasma 17-hydroxyprogesterone concentrations were normal in patients with all types of tumors. However, the ACTH-stimulated plasma 17-hydroxyprogesterone levels were abnormally increased in 53% and 31% of patients with non-hyperfunctioning adenomas and aldosterone-producing adenomas, respectively. In addition, a few patients with adrenal cysts and pheochromocytomas also showed an increased ACTH-stimulated 17- hydroxyprogesterone response. After unilateral adrenalectomy, this hormonal abnormality disappeared in most, although not all patients with adrenal tumors. In patients with non-hyperfunctioning adrenal tumors, ACTH-stimulated plasma 17-hydroxyprogesterone and cortisol concentrations significantly correlated with the size of the tumors. These results firmly indicate that the tumoral mass itself may be responsible for the increased plasma 17-hydroxyprogesterone and cortisol responses after ACTH stimulation in patients with non-hyperfunctioning and hyperfunctioning adrenal adenomas.

Key-words

Adrenal adrenal tumors 17-hydroxyprogesterone response to ACTH 21-hydroxylase Cushing’s syndrome Conn’s syndrome pheochromocytoma 

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Copyright information

© Italian Society of Endocrinology (SIE) 2000

Authors and Affiliations

  • Miklós Tóth
    • 1
  • K. Rácz
    • 1
  • V. Adleff
    • 1
  • I. Varga
    • 1
  • L. Fütö
    • 1
  • C. Jakab
    • 1
  • K. Karlinger
    • 2
  • R. Kiss
    • 1
  • E. Gláz
    • 1
  1. 1.Gastroenterological and Endocrinological Research Group, 2nd Department of MedicineSemmelweis University Medical SchoolBudapestHungary
  2. 2.Department of RadiologySemmelweis University Medical SchoolBudapestHungary

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