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A 38-year-old gravida 2, para 1 woman, who had suffered from virilization and amenorrhoea for 8 years was examined. She had peripheral serum testosterone (T) levels of 3.9\p=n-\8.7ng/ml (normal level: 0.32 \ m=+-\ 0.09 ng/ml) with normal serum levels of dehydroepiandrosterone (DHA), aldosterone and cortisol (F) and normal urinary 17-ketosteroids (17-KS). Dexamethasone (DXM 2 mg/day for 5 days) suppressed the serum F level adequately, but reduced the high T levels only slightly. The administration of commercial hCG 6000 IU for 3 days increased both the serum T levels (5.68 to 9.83 ng/ml) and the serum DHA levels (4.9 to 9.8 ng/ml, normal range 4\p=n-\6 ng/ml), but synthetic ACTH-Z (Cortrosyn-Z\s=r\, 1 mg, Organon) did not affect the serum T level. The basal serum LH level was abnormally low, and constant infusion of synthetic LH-RH (200 \g=m\g/5h) resulted in good responses of serum LH and FSH and increase in the serum T level from 5.2 to 9.1 ng/ml. Computerized tomography, ultrasonography and pneumo-retroperitoneumroentgenography showed the presence of a large tumour in the right adrenal. The tumour was a circumscribed irregularly lobulate mass, measuring 1 6 \ m= x \ 8 \ m= x \ 8 cm and weighing 500 g. Histologically, it was identified as a ganglioneuroma containing numerous scattered groups of large polyhydral cells similar to adrenocortical cells, forming islets in some places. After removal of the tumour from the right adrenal, the high serum T level decreased to the normal female level in 24 h.

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SynopsisThis study was undertaken to determine which biological site or immunological site in the HCG molecule is essential for uptake of HCG by the ovaries. HCG was obtained from the urine of patients with trophoblastic dieseases by adsorption on kaolin. This preparation gave two distinct immunological fractions on Sephadex G-100 column chromatography. One fraction (antigen-1; Ag-1) had both gonadotropic and immunological activities present in HCG, while the other (antigen 2; Ag-2) had only immunological activity of HCG. 131I Ag-1 and 125I Ag-2 were injected into rats intravenously and the localizations of 131I and 125I in each organ and their subcellular fractions were measured by the paired label technique. After injection of HCG, Ag-1 and Ag-2, the activities of ured as an index of steroid biosynthesis. The results obtained were as follows: