C19 urinary steroids in a pregnant ovarian luteoma

Bègue, R.J.; Brun, J.M.; Morinière, M.; Padieu, P.

Journal of Steroid Biochemistry 8(7): 737-742


ISSN/ISBN: 0022-4731
PMID: 201804
DOI: 10.1016/0022-4731(77)90006-1
Accession: 068523862

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C19 steroids were analyzed by gas chromatography and mass spectrometry in the urine of a patient who developed virilizing luteoma during the 8th mo. of pregnancy. Thirty-nine C19 steroids were isolated. The structure of 28 of them was established: sixteen 17-oxosteroids, 5 androstane-3,16,17-triol, three 5-androstene-3,17-diol, 5.beta.-androstane-3.alpha.,17.beta.-diol, 4-androstene-3.alpha.,17.beta.-diol, 3.alpha.-hydroxy-5.alpha.-androst-16-ene, 16.alpha.,17.beta.-dihydroxy-4-androsten-3-one and 5-androstene-3.beta.,16,17.beta.-triol. Two of the other catabolites were 5.zeta.-androstane-2.zeta.,3.zeta.,17.zeta.-triol and two 5-androstene-3.zeta.,15.zeta.,17.zeta.-triols were also present. The total excretion of 17-oxosteroids amounted to 167 mg/day and 90% was due to 5 metabolites: 3.alpha.-hydroxy-5.alpha.-androstan-17-one (95.6 mg), 3.alpha.-hydroxy-5.beta.-androstan-17-one (35.6 mg), 3.beta.-hydroxy-5-androsten-17-one (8.5 mg), 3.alpha.,16.alpha.-dihydroxy-5.alpha.-androstan-17-one (6.3 mg) and 3.alpha.,18-dihydroxy-5.alpha.-androstan-17-one (5.6 mg). Other principal metabolites included 4-androstene-3.alpha.,17.beta.-diol, 5.beta.-androstane-3.alpha.,17.beta.-diol, 5.alpha.-androstane-3.alpha.,16.alpha.,17.beta.-triol and 5.beta.-androstane-3.alpha.,16.alpha.,17.beta.-triol with, respectively, daily excretions of 8.9, 5.1, 2.85 and 2.4 mg and a total of 5-androstene-3.beta.,17.beta.-diol (4.6 mg/24 h). These results confirmed the hyperproduction of 4-androsten-3,17-dione, 17.beta.-hydroxy-4-androsten-3-one and 3.beta.-hydroxy-5-androsten-17-one which were responsible for the maternal virilization syndrome. The absence of any symptom of fetal virilization may be explained by the coincidence of several factors, in particular the date of the appearance of activity of strong androgens, general metabolic activity of the patient and presumably the role of the placenta in the metabolism of the hormones. To determine the role of luteal tissue in C19 steroid production, in the future, intratumor steroids should also be analyzed.