Testosterone and Androstenedione Production Rates in Patients with Metastatic Adrenal Cortical Carcinoma

ABSTRACT Five women with functioning adrenal cortical carcinoma had increased testosterone blood production rates and plasma levels which ranged from high normal to 20 times normal. In a man with feminizing adrenal cortical carcinoma the plasma testosterone was low but the production rate was normal. The testosterone metabolic clearance rates were increased above normal in all 6 patients. In 3 with very large tumors the testosterone metabolic clearance rates were higher than previously observed in patients without neoplastic disease. It is postulated that the large tumors actively metabolized testosterone so as to increase its clearance from the blood compartment. In contrast to testosterone, both androstenedione plasma levels and production rates ranged from normal to very high but in only one patient was the metabolic clearance rate higher than normal. In one patient a major fraction of the plasma testosterone was derived from plasma androstenedione but in 2 others testosterone was either secreted or de...