A premenopausal woman with virilization secondary to an ovarian Leydig cell tumor

Faria, André M.; Perez, Ricardo Vessoni; Marcondes, José Antônio Miguel; Freire, Daniel Soares; Blasbalg, Roberto; Soares, José Maria; Simões, Kleber; Hayashida, Sylvia Asaka Yamashita; Pereira, Maria Adelaide Albergaria

doi:10.1038/nrendo.2011.15

Cited by 16 publications

(18 citation statements)

References 27 publications

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“…Patients usually present with a rapid onset of virilizing symptoms like amenorrhea, hirsutism and clitoromegaly. The presentation of these symptoms in cases of leydig cell tumour is much faster than that due to other causes of hyperandrogenism [8]. However, our case has a relatively insidious progression of symptoms.…”

Section: Case Reportmentioning

confidence: 52%

Pure leydig cell tumour – a rare virilizing tumour in a young female

et al. 2018

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Sex cord stromal cell tumours constitute 5-8% of all ovarian neoplasms of which pure leydig cell tumours constitute 0.1%. These tumours are most commonly found in the post-menopausal age group and patients present with a rapid onset of symptoms of androgen excess like hoarseness of voice, clitoromegaly and hirsutism. We present a case of 39 year old female, who presented with virilising symptoms since 2 years. Serum Testosterone levels were raised and CT revealed homogeneously enhancing mass of 2.8 cm in size in the right ovary. An unilateral oophorectomy was done and sent for histopathological examination. On Gross examination, the ovary revealed the presence of a well circumscribed greyish white tumour with multiple yellowish areas. Microscopy revealed features suggestive of pure leydig cell tumour with reinke crystals. Post operatively, the patient improved symptomatically. The unusual features seen in this case were younger age at presentation and insidious onset of symptoms. The presentation of pure leydig cell tumour-hilar type at such a young age is extremely uncommon.

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Section: Case Reportmentioning

confidence: 52%

Pure leydig cell tumour – a rare virilizing tumour in a young female

et al. 2018

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“…16,18,19 Unfortunately clinical presentation and sonographic appreance cannot predict which mass is malignant. 20 It has been suggested that a simple clinical assessment and a single serum testosterone measurement may be sufficient to differentiate between benign and malignant virilising tumors in women presenting with hirsutism and androgenic features. 21 A dexamethasone suppression test failed to alter basal values, and 17-hydroxyprogesterone levels within normal range, ruled out a potential adrenal source of androgens.…”

Section: Discussionmentioning

confidence: 99%

Ovarian stromal tumor with minor sex-cord element with virilizing menifestations: a rare case report

Sharma

Vij

Mahajan

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…Many of ovarian virilizing tumors are not diagnosed for years, although it seems that, in ovarian tumors, the time to onset of symptoms is usually faster than the other causes of hyperandrogenism (20). Symptoms and signs may present gradually with the onset of symptoms ranging from 5 to 7 years prior the diagnosis (21).…”

Section: Narrative Review Of Literaturementioning

confidence: 99%

Menopausal Androgen Excess - Associated Cardio-Metabolic Risk: Clues for Ovarian Leydig Cell Tumour (Case Report and Mini-Review of Literature)

Gheorghisan-Galateanu

Terzea

Valea

et al. 2017

Acta Endo (Buc)

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Background. Ovarian Leydig cell tumour is a very rare steroid hormones producing mass, causing clinical and biochemical hyperandrogenism. Even if the level of evidence is based on case studies, many authors (but not all) agree that raised androgens increase the cardio-metabolic risk thus early diagnosis and treatment are necessary On the other hand, the endocrine features pointing an ovarian tumour source of testosterone do not indicate the specific histological finding which needs a post-operative conformation.Case presentation. We report a case of a 60-yearold woman with a 4-year history of progressive virilisation in association with hypertension, high number of red blood cells, impaired glucose tolerance and dyslipidemia. Total testosterone was 20 times above normal with suppressed gonadotropins, inadequate for menopause. Trans-vaginal ultrasound and pelvic and abdominal computerized axial tomography imaging revealed a right ovarian solid nodule, and no evidence of alteration in the adrenal glands. Total hysterectomy and bilateral salpingo-oophorectomy were performed. Histopathology and immunohistochemistry confirmed the diagnosis of Leydig cell tumour. After surgery, androgen levels returned to normal and the doses of anti-hypertensive drugs were reduced.Conclusions. The hyperandrogenic state with elevated plasma testosterone and progressive signs of virilization raises suspicion of an ovarian androgen-secreting tumor. For a postmenopausal patient with hyperandrogenism the diagnosis of Leydig cell tumour should be considered. However, the exact diagnosis is provided by post-operative histological exam. Prolonged exposure to hyperandrogenism may generate cardiovascular abnormalities and metabolic syndrome which after tumor excision and removal of the source of androgen hormones are expected to significantly improve.

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A premenopausal woman with virilization secondary to an ovarian Leydig cell tumor

Abstract: The patient underwent a left salpingo-oophorectomy that confirmed the diagnosis of a unilateral Leydig cell tumor. Complete normalization of androgens and gonadotropin levels was achieved after surgery.

Cited by 16 publications

References 27 publications

Pure leydig cell tumour – a rare virilizing tumour in a young female

Pure leydig cell tumour – a rare virilizing tumour in a young female

Ovarian stromal tumor with minor sex-cord element with virilizing menifestations: a rare case report

Menopausal Androgen Excess - Associated Cardio-Metabolic Risk: Clues for Ovarian Leydig Cell Tumour (Case Report and Mini-Review of Literature)

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