Oxidation of dexamethasone in an aqueous suspension by air during prolonged storage produces the 17alpha-formyloxy-17beta-carboxylic acid 4. A pathway to 4 is proposed that involves Baeyer-Villiger-type oxidation of keto aldehyde 1 to mixed anhydride 5, followed by intramolecular formyl transfer. Synthetically, acid 3 was reacted with N,N'-carbonyldiimidazole followed by triethylammonium formate in order to generate the transient anhydride 5 en route to an authentic sample of 4.

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