Abstract
In metastatic adrenal carcinoma, op'DDD has been reported to decrease urinary 17-KS without causing regression of the tumor. This dissociation between the oncolytic and hormonal effects may be explained by our steroidal data. In a 5 y/o girl with metastatic adrenal carcinoma, serum T, Δ4, DHEA, DS and urinary 17-KS were extremely elevated. With op'DDD treatment, the DS and 17-KS fell rapidly while there was a marked delay in the fall of free androgens. The persistence of free steroid secretion with decreased conjugate formation suggests that op'DDD specifically altered sulfatase activity before causing tumor necrosis and total decrease in steroidogenesis. A fall in urinary 17-KS may not indicate tumor regression and serum androgens seem to be a better indicator for the steroidogenic activity of a virilizing adrenal tumor. These data provide some new insight into a drug-steroid interaction.
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