Corticoestroma

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

[1], [2], [3], [4], [5], [6], [7], [8],

Pathogenesis

Feminizing tumors, like virilizing tumors, 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 peculiar to such cortical tumors, with a variety of clinical and biochemical manifestations. Feminizing tumors have a pronounced expansive growth and infiltrate the pericobacterial cellulose and blood and lymphatic vessels quite early.

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

[9], [10], [11], [12], [13]

Symptoms of the corticoestroma

Clinically, the tumor of corticoestroma is characterized in males by the appearance of bilateral gynecomastia, feminization of the physique, sometimes expressed by testicular hypotrophy. It has been experimentally proven long ago that a significant amount of estrogens are secreted by both glucosteromas and androsteromas (mainly malignant ones). Many estrogen in the urine are also found with cancer of the adrenal glands. But, apparently, with these tumors, androgen production negates the manifestations of estrogenic activity in the clinical picture.

One of the early signs should be considered bilateral  gynecomastia, about which some of our patients were operated 2-3 years before the adrenal tumor was detected. Therefore, it is necessary to carry out hormonal studies and in cases of appearance in men in adulthood bilateral gynecomastia. Corticosteromas, manifested only by pure feminization (estroma), are very rare. The majority of patients have, although not very pronounced, signs of increased production and gluco- and mineralocorticoids - obesity, moderate arterial hypertension, weakness, pyoderma, stretch bands.

[14], [15], [16], [17]