PLASMA HORMONE LEVELS AND OESTROGEN PRODUCTION IN A POSTMENOPAUSAL WOMAN WITH ENDOMETRIAL CARCINOMA AND AN OVARIAN THECOMA

SUMMARYPlasma hormone concentrations, the production rate of oestrone from androstenedione, and the total production rate of oestrone have been measured in a 57‐year‐old woman with an ovarian thecoma and endometrial carcinoma before and 2 months after hysterectomy and bilateral ovariectomy. The plasma concentration of oestradiol (184 pmol/l), but not oestrone (144 pmol/l), was elevated pre‐operatively and FSH secretion was suppressed (115.0 μg/l). Post‐operatively the plasma concentration of oestradiol was significantly reduced (80 pmol/l) and the concentration of FSH (571 μg/l) had increased to a postmenopausal level. The concentration of oestradiol in samples of plasma obtained simultaneously at operation from the ovarian vein of the ovary containing the thecoma (3.38 nmol/l) was fifteen times greater than in the periphery (228.0 pmol/l), and this confirmed that oestradiol was secreted by the thecoma. The total production rates of oestrone pre‐and post‐operatively were 101.3 nmo1/24 h and 29.2 nmo1/24 h respectively and the production rates of oestrone from androstenedione were 41.4 nmo1/24 h and 32.9 nmo1/24 h. Thus, postaperatively, all the oestrone was produced from circulating androstenedione, whereas pre‐operatively only 40% of the oestrone was produced by the extraglandular conversion of androstenedione; the remaining 60% presumably originated from the peripheral conversion of oestradiol secreted by the thecoma. It is concluded that the oestradiol secreted by the thecoma was probably the major factor which caused the development of endometrial carcinoma in this subject.