The excretory patterns of urinary steroids determined by capillary gas
chromatography in 11 children (aged 0.8-16.5 years) with adrenocortic
al tumors were established, In 8 patients the predominant clinical fea
ture was virilization, in 3 others, Gushing's syndrome. In 5 patients
(3 carcinoma, 2 adenoma) very high excretion of 3 beta-hydroxy-5-ene s
teroids was observed, In 2 others (adenomas) only moderately elevated
excretion of 11 beta-hydroxyandrosterone was found. In 1 patient (aden
oma) pregnanediol dominated in the steroid profile, accompanied by mod
erately elevated 3 beta-hydroxy-5-ene steroids. Out of 3 Cushingoid pa
tients (1 carcinoma, 2 adenomas), 1 presented an atypical urinary ster
oid pattern for hypercortisolemia, without 5 alpha-reductase and 11 be
ta-hydroxysteroid dehydrogenase deficiencies. Neither the urinary ster
oid pattern nor tumor size alone were reliable indicators of tumor mal
ignancy, as evaluated by a pathological examination and subsequent met
astasis-free survival.