Steroid Production in “Nonfunctioning” Adrenal Cortical Tumor

The urinary steroids in 3 patients with metastatic “nonfunctioning” adrenal tumor have been studied. There was no excessive production of hydrocortisone or adrenal androgen metabolites. However, the isolation of rather large amounts of Δ5-pregnene-3β,20α-diol and pregnane-3α,20α-diol from 2 patients indicates that the metastases were at least capable of the first step in corticosteroid biosynthesis—cholesterol to pregnenolone. There was further evidence of a relative inability to oxidize the C-3 hydroxyl group and to rearrange the 5,6-double bond. Δ5-Pregnene-3α,16α,20α-triol was isolated from the urine of one of these patients. There was an absence of abnormal steroids in the third patient studied.