Corticoestroma

Corticoestroma is a very rare tumor of the adrenal cortex. It has been described only in men. To date, less than 100 cases have been reported in the literature. Corticoestromas are mostly malignant and can reach large sizes - up to 800-1200 g. Estroma is a tumor of the adrenal cortex that produces large amounts of female sex hormones - estrogens.

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Pathogenesis

Feminizing tumors, like virilizing ones, can reach large sizes, but more often their mass is up to 50-100 g. As a rule, they are malignant with all the morphological features characteristic of such cortical tumors, with various clinical and biochemical manifestations. Feminizing tumors have pronounced expansive growth and quite early infiltrate the perirenal tissue and blood and lymphatic vessels.

It should be emphasized that it is not possible to morphologically identify different hormonal variants of cortical tumors, especially among malignant ones. With the same structure, they can produce different corticosteroids, and morphologically different tumors often produce the same class of hormones.

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Symptoms corticoestromas

Clinically, the corticoestroma tumor is characterized in males by the appearance of bilateral gynecomastia, feminization of the physique, and sometimes pronounced testicular hypotrophy. It has long been experimentally proven that glucosteromas and androsteromas (mostly malignant) secrete a significant amount of estrogens. Many estrogens are also found in urine in adrenal cancer. But, apparently, in the above tumors, the production of androgens levels out the manifestations of estrogenic activity in the clinical picture.

One of the early signs should be considered bilateral gynecomastia, for which some of our patients were operated 2-3 years before the discovery of the adrenal tumor. Therefore, it is necessary to conduct hormonal studies in cases of bilateral gynecomastia in men in adulthood. Corticosteromas, manifested only by pure feminization (estroms), are very rare. Most patients have signs of increased production of both gluco- and mineralocorticoids, although not clearly expressed - obesity, moderate arterial hypertension, weakness, pyoderma, stretch marks.

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