[A case of virilizing adrenocortical carcinoma in an adult female with increased urinary excretion of catecholamines].

We report a rare case of virilizing adrenocortical carcinoma with increased urinary excretion of catecholamines. A 53-year-old woman was admitted because of a huge abdominal mass. A child's-head-size mass was palpable in the right upper quadrant. IVP, CT scan and angiography revealed a characteristic picture of an adrenal tumor. Urinary catecholamines and vanilmandelic acid were increased slightly. The urinary 17 ketosteroid level was very high (59.0 mg per day) and was not suppressed by a dexamethasone test. Exploratory laparotomy revealed that the tumor was fixed and had infiltrated to the vena cava, aorta and liver. Therefore, chemotherapy was performed. The dosage of op'-DDD was increased gradually to 9 g daily. During this treatment, a 5-days' course of treatment with cis-platinum (50 mg/day) was repeated 2 times. This patient achieved partial response according to Koyama-Saito's criteria. However, she died 18 months after the first admission. On autopsy, determined histopathologically that she died of adrenocortical carcinoma arising from the adrenal gland. However systemic lymph node, bone and lung metastases were also revealed. There is a possibility that this tumor secreted both sex steroids and catecholamines.