Contribution of plasma dehydroepiandrosterone sulfate to testosterone in a virilized patient with an arrhenoblastoma

The conversion of dehydroepiandrosterone sulfate (DS) to testosterone (T) and the DS production rate were quantified preand postoperatively in a virilized 32-yr-old female with an arrhenoblastoma. Additionally, at the time of operation, the tumor was isolated and perfused with DS-4-¹⁴C and T-7α-³H and the venous effluent collected. Preoperatively, the maximum quantity of plasma T derived from circulating DS was 640 µg/day. Postoperatively, this figure was found to be 310 µg/day. The preoperative DS production rate was 80 mg/day, with the postoperative production rate falling to 15.5 mg/day. Labeled DS perfused through the tumor was not converted to T, testosterone sulfate or androstenedione. A small conversion of DS to dehydroepiandrosterone was noted. It is concluded that the conversion of circulating DS to T by the tumor itself was not an important factor in the genesis of this patient’s virilism. Likewise, the peripheral conversion of circulating DS to T did not appear to be significant in terms of the clinical status of the patient. The tumor was the major source of circulating DS prior to operation.