J.Jpn. Surg. Soc.. 80(11): 1027-1031, 1979

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Report on the annual meeting

PLASMA STEROID PATTERNS AND ITS INFLUENCE TO THE SURGICAL PROCEDURES IN VARIOUS TYPES OF CUSHING'S SYNDROME

Plasma concentrations of 12 steroids were determined in thirty cases of Cushing's syndromes. In hyperplasias, all steroids including androgens increased, but aldosterone. In adenomas, not only glucocorticoids but mineralocorticoids were increased in concomitance with decreased androgens. There were interesting enough to notice that the steroid studies correlated considerably to the clinical symptomes, such as hirsutism in hyperplasias and hypokalemic hypertension in adenomas. Similar patterns to adenomas were obtained in nodular hyperplasias. Extremely high levels of corticosterone were seemed to be characteristic in ectopic ACTH syndromes, and the main cause of severe metabolic alkalosis. In recurrent Cushing's syndrome after total or subtotal adrenalectomy showed no more hyperplasia-patterns, and some alterations of enzymatic activities were suggested from the relative high levels of 11-deoxycortisol and 11-deoxycorticosterone. In a case of adrenal cancer which showed no obvious Cushingoid symptomes, it was detected to have a 11-hydroxylase deficiency. Therefore, various abnormalities of steroid patterns, particularly mineralocorticoids, in any type of Cushing's syndromes, should be taken into consideration for surgical procedures.

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