AUTHOR=Abe Ichiro , Yamazaki Yuto , Higashi Ayuko , Ochi Kentaro , Kubo Keita , Fujita Yuya , Takeshita Kaori , Wada Toshiaki , Mitsuoka Ryo , Yamashita Yo , Yoshida Ryoko , Kato Tamotsu , Kudo Tadachika , Miyajima Shigero , Ishii Tatsu , Nimura Satoshi , Suzuki Takashi , Sasano Hironobu , Kobayashi Kunihisa 

TITLE=Case Report: Adrenocortical adenoma harboring atypical subclinical Cushing’s syndrome with dehydroepiandrosterone sulfate transferase and cytochrome b5 expression in tumor cells

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1624396

DOI=10.3389/fendo.2025.1624396

ISSN=1664-2392

ABSTRACT=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.