Ovarian hilus cell hyperplasia as the cause of virilization in 45,X Turner’s syndrome

Damle, Lauren F.; Gómez-Lobo, Veronica; Andrus, Amy R.; Kaplowitz, Paul B.

doi:10.1016/j.fertnstert.2011.03.068

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…However, no patients in these series were said to have had HCC. In one girl with TS and hilus cell hyperplasia who was similar to our patient but without mention of liver tumors, gonadectomy did result in normalization of T over a 3-month period [ 13 ].…”

Section: Discussionmentioning

confidence: 85%

Hepatocellular Carcinoma, Virilization, and Hilus Cell Hyperplasia in a Girl With Turner Syndrome

Law

Lee

Sasatomi

et al. 2018

Journal of the Endocrine Society

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Patients with Turner syndrome (TS) are known to be at risk for excess androgen production and virilization associated with gonadoblastoma and Y chromosome mosaicism, and excess androgens are a risk factor for the development of hepatocellular carcinoma. However, virilization and hepatocellular carcinoma have not been described in a patient with TS. A 10-year-old with nonmosaic 45,X TS presented with clitoromegaly, accelerated linear growth velocity, advanced bone age, and elevated testosterone levels as well as a second occurrence of hepatocellular carcinoma. Gonadectomy was performed, and pathology revealed hilus cell hyperplasia. Immunohistochemical staining of both the original and recurrent hepatocellular carcinoma tissues was diffusely positive for androgen receptors. After gonadectomy, testosterone levels were measurable but normal, with no further virilization; however, the liver mass continued to grow. Ovarian hilus cell hyperplasia should be considered a potential etiology for virilization in the TS population. Excess endogenous testosterone exposure in girls and women with TS may be associated with hepatocellular carcinoma expressing the androgen receptor, though normalizing testosterone levels may not lead to tumor regression in these cases.

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Section: Discussionmentioning

confidence: 85%