Androgenproduzierender Leydig-Zell-Tumor des Ovars als Ursache von Hirsutismus bei einer postmenopausalen Frau

Matuszczyk, Anna; Petersenn, Stephan; Lahner, Harald; Haude, Michael; Veit, Patrick; Becker, Jan U.; Bockisch, Andreas; Mann, Klaus

doi:10.1007/s00063-007-1032-5

Cited by 14 publications

(3 citation statements)

References 14 publications

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“…According to the previous literature, PET-CT with MRI or selective catheterization were used to detect androgen-producing ovarian tumors not found in ultrasonography and abdominopelvic CT [9,10]. These cases also demonstrate the potential diagnostic power of PET-CT in detecting SLCT.…”

Section: Discussionmentioning

confidence: 97%

Diagnosis of an indistinct Leydig cell tumor by positron emission tomography-computed tomography

et al. 2019

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A 51-year-old perimenopausal female patient presented with hirsutism and voice thickening which was started approximately one and a half years ago. Her initial hormone assay revealed elevated plasma testosterone, 5a-dihydrotestosterone, and dehydroepiandrosterone (DHEA) levels and therefore androgen-secreting tumor was first suspected. However, the lesion was inconspicuous on transvaginal sonography, abdominal-pelvic computed tomography (CT) scan, and pelvic magnetic resonance (MRI) imaging. Consequently, 18 F-fluorodeoxyglucose (FDG) positron emission tomography-CT was performed, which localized the lesion as a focal FDG uptake within the right adnexa. Total laparoscopic hysterectomy with bilateral salpingo-oophorectomy was performed, and although visible gross mass lesions were not observed intraoperatively, pure Leydig cell tumor was pathologically confirmed within the right ovary. Plasma testosterone, 5a-dihydrotestosterone, and DHEA levels were normalized postoperatively. Clinical signs of virilization were also significantly resolved after 3-months of follow-up.

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Section: Discussionmentioning

confidence: 97%

Diagnosis of an indistinct Leydig cell tumor by positron emission tomography-computed tomography

et al. 2019

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“…When the provocative test is inconclusive, in some cases, it may be necessary to require catheterisation of the ovarian veins to confirm the site of androgen production [5,6,11]. The literature also describes the use of F-18 fluoro- D -glucose-positron emission tomography-computed tomography (FDG-PET/CT) for the location of these tumours [12,13]. …”

Section: Discussionmentioning

confidence: 99%

Leydig Cell Tumour in a 46,XX Child with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

Lázaro

Lacerda²,

Ghiaroni³

et al. 2013

Horm Res Paediatr

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Case Report: A 10-year-old male was referred to our institution due to short stature and bilateral cryptorchidism and reported pubic hair development and acne since the age of 4 years. Laboratory and molecular genetic tests indicated congenital adrenal hyperplasia due to 21-hydroxylase deficiency. After treatment with prednisone, adrenal hormones normalised but testosterone remained elevated. Magnetic resonance imaging of the abdomen due to cryptorchidism revealed uterus and adnexal attachments, a prostate and poorly defined nodules on the iliac chains. Upon exploratory laparotomy, a hysterectomy, bilateral oophorectomy and resection of a peri-adnexal nodular lesion on the patient's right side were performed. Histopathology of the nodule mass was compatible with a Leydig cell tumour with a low proliferation rate according to Ki67.

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“…The preferred methods today are transvaginal ultrasound with certain color fl ow Doppler measurements ( Outwater et al, 2000 ) and magnetic resonance imaging ( Tanaka et al, 2004 ). Another possibility to detect these small tumors are (18F) FDG-PET / CT scans, using pathologic glucose utilization as mode of visualization ( Matuszczyk et al, 2007 ). Selective venous catheterization of the ovarian and adrenal veins was favoured especially in earlier years ( Surrey et al, 1988, Kirschner, 1983 ) because of the low resolution of most of the imaging techniques available at that time.…”

Section: Postoperative Fi Ndingsmentioning

confidence: 99%

Leydig-Cell-Tumor of the Ovary that Responded to GnRH-Analogue Administration – Case Report and Review of the Literature

Klotz

Müller‐Holzner

Fessler

et al. 2010

Exp Clin Endocrinol Diabetes

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Progressive hirsutism can be a symptom of an androgen-producing tumor, especially in postmenopausal women. We report a case of a 58-year-old woman who complained of progressive hirsutism, nervousness, irritability, anxiousness and an increased libido. Examination showed an unusual redness of her head, décolleté, palms and soles of her feet. Basal laboratory tests revealed a profound elevation of testosterone levels (7.5 microg/l) and normal levels of androstendione, dehydroepiandrosterone-sulfate, 17alpha-hydroxy-progesterone and thyroid-stimulating hormone. Also remarkable was that her red blood count, hemoglobin and hematocrit values were elevated while erythropoietin was within normal limits. Functional laboratory tests ruled out heterozygous C21-hydroxylase deficiency and showed a moderate insulin resistance on the oral glucose tolerance test. Transvaginal ultrasound revealed a slightly hyperdensic area of 6 mm in the left ovary. Magnetic resonance imaging showed a contrast medium-accumulating area of 2 cm in the left ovary. Since the patient was initially reluctant to undergo surgery, a GnRH-analogue (triptoreline) was administered VIA intramuscular injection once per month for two months and testosterone levels were lowered to less than one third of the initial level (2 microg/l). Surgery was eventually performed with laparoscopic bilateral salpingoophorectomy, hysteroscopy and uterine curettage. The histologic examination revealed a Leydig cell tumor in the hilus and stroma of the left ovary. Postoperatively testosterone levels dropped dramatically and instantly into the normal range. Within months, the red blood count and hematocrit levels were within normal limits. The patient's face became more feminine, the redness of her face and hirsutism regressed. Her anxiousness and nervosity resolved and the insulin sensitivity improved. In this paper, polyglobulia, the metabolic and psychological changes due to hyperandrogenism are discussed, as well as the phenomenon that the tumor responded to a GnRH-analogue. Such a response implies that the tumor is either under gonadotropin control or that GnRH analogues have direct effects via receptors on tumorous Leydig cells.

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Androgenproduzierender Leydig-Zell-Tumor des Ovars als Ursache von Hirsutismus bei einer postmenopausalen Frau

Abstract: Selective catheterization and [(18)F]FDG-PET investigation may aid the detection of androgen-secreting tumors.

Cited by 14 publications

References 14 publications

Diagnosis of an indistinct Leydig cell tumor by positron emission tomography-computed tomography

Diagnosis of an indistinct Leydig cell tumor by positron emission tomography-computed tomography

Leydig Cell Tumour in a 46,XX Child with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

Leydig-Cell-Tumor of the Ovary that Responded to GnRH-Analogue Administration – Case Report and Review of the Literature

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