Feminizing Adrenal Carcinoma Presenting with Heart Failure and Ventricular Tachycardia

We present a case of feminizing adrenal carcinoma with severe elevation in serum estradiol and otherwise unexplained congestive heart failure with ventricular arrhythmia and review the literature on feminizing adrenal tumors and the potential relationship between estrogen and cardiac problems. A 54-...

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Main Authors: Anjana Harnoor, R. Lee West, Fiona J. Cook
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2012/760134
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author Anjana Harnoor
R. Lee West
Fiona J. Cook
author_facet Anjana Harnoor
R. Lee West
Fiona J. Cook
author_sort Anjana Harnoor
collection DOAJ
description We present a case of feminizing adrenal carcinoma with severe elevation in serum estradiol and otherwise unexplained congestive heart failure with ventricular arrhythmia and review the literature on feminizing adrenal tumors and the potential relationship between estrogen and cardiac problems. A 54-year-old man presented with congestive heart failure and ventricular arrhythmia. Imaging revealed a large adrenal mass. Hormonal evaluation revealed a very high serum level of estradiol, elevated DHEA-sulfate and androstenedione, and lack of cortisol suppression on a low-dose overnight dexamethasone suppression test. The patient underwent a left adrenalectomy with subsequent normalization of serum estradiol. Surgical pathology examination established adrenocortical carcinoma MacFarlane stage II. Upon 15-month followup, the patient continued to have a normal serum estradiol level, his cardiac function was significantly improved, and he had no further episodes of ventricular arrhythmia. To the best of our knowledge, the serum estradiol level that was detected in our case is the highest that has been reported. Further, we hypothesize that the very high serum concentration of estradiol in our case may have played a role in his cardiac presentation with congestive heart failure and arrhythmia, particularly as these problems resolved with normalization of his serum estradiol level.
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spelling doaj-art-40c42bbb7d2c45f58e8869d1260e803a2025-08-20T02:39:15ZengWileyCase Reports in Endocrinology2090-65012090-651X2012-01-01201210.1155/2012/760134760134Feminizing Adrenal Carcinoma Presenting with Heart Failure and Ventricular TachycardiaAnjana Harnoor0R. Lee West1Fiona J. Cook2Division of Endocrinology, Department of Internal Medicine and The Department of Pathology, Brody School of Medicine at East Carolina University, Greenville, NC 27834, USADivision of Endocrinology, Department of Internal Medicine and The Department of Pathology, Brody School of Medicine at East Carolina University, Greenville, NC 27834, USADivision of Endocrinology, Department of Internal Medicine and The Department of Pathology, Brody School of Medicine at East Carolina University, Greenville, NC 27834, USAWe present a case of feminizing adrenal carcinoma with severe elevation in serum estradiol and otherwise unexplained congestive heart failure with ventricular arrhythmia and review the literature on feminizing adrenal tumors and the potential relationship between estrogen and cardiac problems. A 54-year-old man presented with congestive heart failure and ventricular arrhythmia. Imaging revealed a large adrenal mass. Hormonal evaluation revealed a very high serum level of estradiol, elevated DHEA-sulfate and androstenedione, and lack of cortisol suppression on a low-dose overnight dexamethasone suppression test. The patient underwent a left adrenalectomy with subsequent normalization of serum estradiol. Surgical pathology examination established adrenocortical carcinoma MacFarlane stage II. Upon 15-month followup, the patient continued to have a normal serum estradiol level, his cardiac function was significantly improved, and he had no further episodes of ventricular arrhythmia. To the best of our knowledge, the serum estradiol level that was detected in our case is the highest that has been reported. Further, we hypothesize that the very high serum concentration of estradiol in our case may have played a role in his cardiac presentation with congestive heart failure and arrhythmia, particularly as these problems resolved with normalization of his serum estradiol level.http://dx.doi.org/10.1155/2012/760134
spellingShingle Anjana Harnoor
R. Lee West
Fiona J. Cook
Feminizing Adrenal Carcinoma Presenting with Heart Failure and Ventricular Tachycardia
Case Reports in Endocrinology
title Feminizing Adrenal Carcinoma Presenting with Heart Failure and Ventricular Tachycardia
title_full Feminizing Adrenal Carcinoma Presenting with Heart Failure and Ventricular Tachycardia
title_fullStr Feminizing Adrenal Carcinoma Presenting with Heart Failure and Ventricular Tachycardia
title_full_unstemmed Feminizing Adrenal Carcinoma Presenting with Heart Failure and Ventricular Tachycardia
title_short Feminizing Adrenal Carcinoma Presenting with Heart Failure and Ventricular Tachycardia
title_sort feminizing adrenal carcinoma presenting with heart failure and ventricular tachycardia
url http://dx.doi.org/10.1155/2012/760134
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