Home A case of mature teratoma with a falsely high serum estradiol value measured with an immunoassay
Article
Licensed
Unlicensed Requires Authentication

A case of mature teratoma with a falsely high serum estradiol value measured with an immunoassay

  • Mayumi Hosokawa , Hironori Shibata , Tomohiro Ishii , Akihiro Fujino , Tatsuo Kuroda , Kenjiro Kosaki , Kaori Kameyama and Tomonobu Hasegawa EMAIL logo
Published/Copyright: March 12, 2016
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 29 Issue 6

Abstract

Background: Immunoassays (IAs) are widely used to measure concentration of serum estradiol (E2) despite some limitations including cross-reactivity. Liquid chromatography-tandem mass spectrometory (LC-MS/MS) for E2 measurement has a theoretically greater specificity and sensitivity than IAs. We report a case with unexpected discrepancy in E2 values measured by IA and LC-MS/MS.

Case presentation: A 7-year-old girl was referred because of an ovarian tumor. Physical examinations revealed prepubertal statuses. Serum E2 with ECLIA was 69 pg/mL. GnRH stimulation test revealed a prepubertal response. On imaging studies, the diagnosis was mature teratoma of the right ovary. After tumor enucleation, the diagnosis was pathologically confirmed. E2 with ECLIA decreased to 11 pg/mL. Preoperative E2 with LC-MS/MS was 1.15 pg/mL.

Conclusions: We conclude the preoperative E2 with ECLIA was falsely high. We speculate the antibody used in ECLIA had cross-reactivity to endogenous compounds. LC-MS/MS should be considered when high serum E2 measured with IA is inconsistent with physical and/or endocrinological data.

Keywords: falsely high value; immunoassays; LC-MS/MS; serum estradiol
Corresponding author: Tomonobu Hasegawa, MD, PhD, Division of Endocrinology and Metabolism, Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 165-8582, Japan, Phone: +81-3-5363-3816, Fax: +81-3-53791978, E-mail:

References

1. Krasowski MD, Drees D, Morris CS, Maakestad J, Blau JL, et al. Cross-reactivity of steroid hormone immunoassays: slinical significance and two-dimensional molecular similarity prediction. BMC Clin Pathol 2014;14:33.10.1186/1472-6890-14-33Search in Google Scholar PubMed PubMed Central

2. Kaplowitz P, Soldin SJ. Steroid profiles in serum by liquid chromatography-tandem mass spectrometry in infants with genital hair. J Pediatr Endocrinol Metab 2007;20:597–605.10.1515/JPEM.2007.20.5.597Search in Google Scholar PubMed

3. Rosner W, Hankinson SE, Sluss PM, Vesper HW, Wierman ME. Challenges to the measurement of estradiol: an endocrine society position statement. J Clin Endocrinol Metab 2013;98:1376–87.10.1210/jc.2012-3780Search in Google Scholar PubMed PubMed Central

4. Japan Patent Office. Patent & utility model number search. Available at: https://www4.j-platpat.inpit.go.jp/eng/tokujitsu/tkbs_en/TKBS_EN_GM101_Top.action. Kind: A:Publication of patent application, Document Number: 2014-16329.Search in Google Scholar

5. Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist, 2nd ed. Stanford, CA, Stanford University Press, 1959.10.1097/00000441-195909000-00030Search in Google Scholar

6. Koyama Y, Homma K. Urinary steroid profiling: a powerful method for the diagnosis of abnormal steroidogenesis. Exp Rev Endocrino Metab 2014;9:273–82.10.1586/17446651.2014.904199Search in Google Scholar PubMed

Received: 2015-11-17
Accepted: 2016-1-25
Published Online: 2016-3-12
Published in Print: 2016-6-1

©2016 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Medullary thyroid carcinoma: a review on ethical considerations in treatment of children
  4. Original Articles
  5. Monocyte chemoattractant protein 1 and macrophage migration inhibitory factor in children with type 1 diabetes
  6. Organ-specific autoimmunity in relation to clinical characteristics in children with long-lasting type 1 diabetes
  7. Seasonality of diagnosis of type 1 diabetes mellitus in the Netherlands (Young Dudes-2)
  8. Health-related quality of life in children and adolescents with type 1 diabetes mellitus from Montenegro: relationship to metabolic control
  9. Relation of fetuin A levels with cardiac, subcutaneous lipid accumulation and insulin resistance parameters in Turkish obese children
  10. Prooxidant-antioxidant balance in patients with phenylketonuria and its correlation to biochemical and hematological parameters
  11. Serum vaspin concentrations in girls with anorexia nervosa
  12. Effect of intramuscular cholecalciferol megadose in children with nutritional rickets
  13. Focus on BMI and subclinical hypothyroidism in adolescent girls first examined for amenorrhea or oligomenorrhea. The emerging role of polycystic ovary syndrome
  14. Absence of a relationship between thyroid hormones and vitamin D levels
  15. Parathyroid hormone-ionized calcium dynamics over the first year of life
  16. Biochemical markers of bone turnover in children with clinical bone fragility
  17. Adipocytokines and bone metabolism markers in relation to bone mineral values in early pubertal boys with different physical activity
  18. Bone mineral density in young Chilean patients with type 1 diabetes mellitus
  19. Case Reports
  20. A case of mature teratoma with a falsely high serum estradiol value measured with an immunoassay
  21. Leigh syndrome associated with a novel mutation in the COX15 gene
  22. More than one way to skin a thyroid. Managing pediatric hypothyroidism with weekly intramuscular levothyroxine
  23. First case report of rare congenital adrenal insufficiency caused by mutations in the CYP11A1 gene in the Czech Republic
  24. Arg924X homozygous mutation in insulin receptor gene in a Tunisian patient with Donohue syndrome
  25. Corrigendum
  26. Corrigendum to: Exposure to sunshine early in life prevented development of type 1 diabetes in Danish boys
https://doi.org/10.1515/jpem-2015-0442
Keywords for this article
falsely high value; immunoassays; LC-MS/MS; serum estradiol

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Medullary thyroid carcinoma: a review on ethical considerations in treatment of children
  4. Original Articles
  5. Monocyte chemoattractant protein 1 and macrophage migration inhibitory factor in children with type 1 diabetes
  6. Organ-specific autoimmunity in relation to clinical characteristics in children with long-lasting type 1 diabetes
  7. Seasonality of diagnosis of type 1 diabetes mellitus in the Netherlands (Young Dudes-2)
  8. Health-related quality of life in children and adolescents with type 1 diabetes mellitus from Montenegro: relationship to metabolic control
  9. Relation of fetuin A levels with cardiac, subcutaneous lipid accumulation and insulin resistance parameters in Turkish obese children
  10. Prooxidant-antioxidant balance in patients with phenylketonuria and its correlation to biochemical and hematological parameters
  11. Serum vaspin concentrations in girls with anorexia nervosa
  12. Effect of intramuscular cholecalciferol megadose in children with nutritional rickets
  13. Focus on BMI and subclinical hypothyroidism in adolescent girls first examined for amenorrhea or oligomenorrhea. The emerging role of polycystic ovary syndrome
  14. Absence of a relationship between thyroid hormones and vitamin D levels
  15. Parathyroid hormone-ionized calcium dynamics over the first year of life
  16. Biochemical markers of bone turnover in children with clinical bone fragility
  17. Adipocytokines and bone metabolism markers in relation to bone mineral values in early pubertal boys with different physical activity
  18. Bone mineral density in young Chilean patients with type 1 diabetes mellitus
  19. Case Reports
  20. A case of mature teratoma with a falsely high serum estradiol value measured with an immunoassay
  21. Leigh syndrome associated with a novel mutation in the COX15 gene
  22. More than one way to skin a thyroid. Managing pediatric hypothyroidism with weekly intramuscular levothyroxine
  23. First case report of rare congenital adrenal insufficiency caused by mutations in the CYP11A1 gene in the Czech Republic
  24. Arg924X homozygous mutation in insulin receptor gene in a Tunisian patient with Donohue syndrome
  25. Corrigendum
  26. Corrigendum to: Exposure to sunshine early in life prevented development of type 1 diabetes in Danish boys
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 27.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2015-0442/html
Scroll to top button