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CASE REPORT article

Front. Endocrinol.

Sec. Neuroendocrine Science

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1624396

Adrenocortical adenoma harboring atypical subclinical Cushing's syndrome with dehydroepiandrosterone sulfate transferase and cytochrome b5 expression in tumor cells

Provisionally accepted
Ichiro AbeIchiro Abe1*Yuto YamazakiYuto Yamazaki2Ayuko HigashiAyuko Higashi1Kentaro OchiKentaro Ochi1Keita KuboKeita Kubo1Yuya FujitaYuya Fujita1Kaori TakeshitaKaori Takeshita1Toshiaki WadaToshiaki Wada1Ryo MitsuokaRyo Mitsuoka1Yo YamashitaYo Yamashita1Ryoko YoshidaRyoko Yoshida1Tamotsu KatoTamotsu Kato1Tadachika KudoTadachika Kudo1Shigero MiyajimaShigero Miyajima3Tatsu IshiiTatsu Ishii3Satoshi NimuraSatoshi Nimura4Takashi SuzukiTakashi Suzuki2Hironobu SasanoHironobu Sasano2Kunihisa KobayashiKunihisa Kobayashi1
  • 1Chikushino, Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Fukuoka, Japan
  • 2Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
  • 3Chikushino, Department of Urology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
  • 4Chikushino, Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan

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Subclinical Cushing's syndrome (SCS) is frequently encountered during the clinical evaluation of adrenal incidentalomas and is typically associated with reduced levels of serum dehydroepiandrosterone sulfate (DHEA-S). Cytochrome b5 is a component of the electron transfer system that enhances the activity of 17, 20-lyase relative to that of 17a-hydroxylase.Therefore, tumors harboring cytochrome b5 might be associated with dehydroepiandrosterone sulfotransferase (DHEA-ST) expression, resulting in unsuppressed serum DHEA-S levels.Here, we reported the first case of SCS with elevated serum DHEA-S levels in an incidentally detected adrenocortical adenoma showing immunohistochemical positivity for both cytochrome b5 and DHEA-ST.

Keywords: Subclinical Cushing's syndrome, hypercortisonemia, Dehydroepiandrosterone, cytochrome b5, Electron transfer system

Received: 07 May 2025; Accepted: 03 Jul 2025.

Copyright: © 2025 Abe, Yamazaki, Higashi, Ochi, Kubo, Fujita, Takeshita, Wada, Mitsuoka, Yamashita, Yoshida, Kato, Kudo, Miyajima, Ishii, Nimura, Suzuki, Sasano and Kobayashi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ichiro Abe, Chikushino, Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Fukuoka, Japan

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