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April 1965

Estrogen Hyperexcretion in a Patient With Nonendocrine Cancer

Author Affiliations


Director, Oncology Division, Medical Services, Lemuel Shattuck Hospital, Department of Public Health, Commonwealth of Massachusetts; Assistant Professor of Medicine, Tufts University School of Medicine.

Arch Intern Med. 1965;115(4):464-467. doi:10.1001/archinte.1965.03860160090015

DURING recent years, the association of adrenocortical hyperfunction and nonendocrine tumors has been noted. Elevation of serum hydroxycorticoids and of urinary 17-hydroxyand/or 17-ketogenic steroids has been found associated with carcinomatous states, principally in patients with bronchogenic cancer of the oatcell type, thymomas, and pancreatic cancer.1-3 Increased corticotropin-like activity has been demonstrated in plasma and in tumor tissue extracts obtained from patients with these malignancies and may account for the adrenocortical hyperfunction.4 Widening of the adrenal cortex at postmortem examination has been noted in patients with malignancy, especially with bronchogenic carcinoma.5,6

In the case to be reported, an excessive amount of urinary estrogen was found in a patient with a highly anaplastic carcinoma. At postmortem examination, widening of the adrenal cortex was demonstrated. This patient developed striking spider angiomata and pulmonary osteoarthropathy during the late stage of his rapid illness, suggesting a causal relationship with the elevated