Unexpected discrepancies between steroid intra-tissular content in adrenal tumors and clinical diagnosis of steroid excess
Authors' conclusion
Discrepancies observed between steroid levels measured in ACT tissue and clinical diagnosis of steroid excess suggest a dysregulation of steroid export depending on tumor type, opening new perspectives for diagnosis and treatment of steroid excess.
Study context
- Population
- Frozen tissue samples of adrenocortical tumors, Cushing's disease and normal adrenals
- Participants
- 75 / 7 / 9
- Comparison
- Intra-tissular steroid content in adrenocortical tumor (ACT) vs Cushing's disease and normal adrenal tissue, and vs clinical diagnosis of steroid excess
- ACTn = 75
- Cushing's diseasen = 7
- Normal adrenalsn = 9reference
- Outcome
- Profile of 13 steroids in tissue by ultra-high-performance liquid chromatography–tandem mass spectrometry, compared with clinical diagnosis of steroid excess
Main finding
As reported in the abstract
Intra-tissular steroid content
- Steroid levels 10-1000 times higher in normal adrenal tissue than normal concentrations expected in blood
- Tissue/blood concentration ratios in normal adrenal lower for distal products than for steroid precursors
- In adrenocortical cancers, intra-tissular steroid content lower than in unilateral benign tumors despite clear clinical steroid excess
- In overt-Cushing adenomas, intra-tissular cortisol not higher and androstenedione not lower than in non-functioning adenomas
- Transcriptome-based adrenal differentiation score well correlated with intra-tissular cortisol
Original publication
Unexpected discrepancies between steroid intra-tissular content in adrenal tumors and clinical diagnosis of steroid excess. Eur J Endocrinol. Published 14 June 2025. doi:10.
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