Ovarian hyperthecosis on grayscale and color Doppler ultrasound

Rousset, Pascal; Gompel, A Van; Christin-Maître, Sophie; Pugeat, Michel; Hugol, D.; Ghossain, M.

doi:10.1002/uog.6131

Cited by 37 publications

(22 citation statements)

References 23 publications

(26 reference statements)

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“…In ovarian tumours, raised testosterone may be LH-dependent and in some cases can be suppressed by treatment with gonadotrophin-releasing hormone (GNRH) agonist, oestrogen-progestogen or cyproterone acetate (CPA) (70). However, it should be noted that hyperthecosis and ovarian androgen-secreting tumours are both LH-dependent and therefore should be further explored by complementary imaging (71). More rarely, raised total serum testosterone can be associated with a marked elevation of SHBG possibly as the result of use of medication having an oestrogenic effect (tamoxifen and raloxifene), or of hyperthyroidism or liver disease, particularly portal hypertension with primary cirrhosis (57).…”

Section: Laboratory and Biomarkersmentioning

confidence: 99%

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Conway¹,

Dewailly²,

Diamanti-Kandarakis³

et al. 2014

European Journal of Endocrinology

569

492

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Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. Great efforts have been made in the last 2 decades to define the syndrome. The presence of three different definitions for the diagnosis of PCOS reflects the phenotypic heterogeneity of the syndrome. Major criteria are required for the diagnosis, which in turn identifies different phenotypes according to the combination of different criteria. In addition, the relevant impact of metabolic issues, specifically insulin resistance and obesity, on the pathogenesis of PCOS, and the susceptibility to develop earlier than expected glucose intolerance states, including type 2 diabetes, has supported the notion that these aspects should be considered when defining the PCOS phenotype and planning potential therapeutic strategies in an affected subject. This paper offers a critical endocrine and European perspective on the debate on the definition of PCOS and summarises all major aspects related to aetiological factors, including early life events, potentially involved in the development of the disorder. Diagnostic tools of PCOS are also discussed, with emphasis on the laboratory evaluation of androgens and other potential biomarkers of ovarian and metabolic dysfunctions. We have also paid specific attention to the role of obesity, sleep disorders and neuropsychological aspects of PCOS and on the relevant pathogenetic aspects of cardiovascular risk factors. In addition, we have discussed how to target treatment choices based according to the phenotype and individual patient's needs. Finally, we have suggested potential areas of translational and clinical research for the future with specific emphasis on hormonal and metabolic aspects of PCOS.

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Section: Laboratory and Biomarkersmentioning

confidence: 99%

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Conway¹,

Dewailly²,

Diamanti-Kandarakis³

et al. 2014

European Journal of Endocrinology

569

492

View full text Add to dashboard Cite

show abstract

“…This typically bilateral condition is characterized by a hyperplastic ovarian stroma associated with cellular luteinization and is believed to result from abnormal ovarian steroidogenesis secondary to gonadotropic stromal hyperstimulation (10)(11)(12)(13). It is classically associated with insulin resistance and hyperinsulinemia in almost all reported cases (12,14,15), but, in contrast to polycystic ovary syndrome, the mechanisms correlating hyperinsulinemia and hyperthecosis remain unstudied (16)(17)(18). This pathology is benign and must be differentiated from androgen-producing tumors.…”

Section: Introductionmentioning

confidence: 99%

Impact of clinical, hormonal, radiological, and immunohistochemical studies on the diagnosis of postmenopausal hyperandrogenism

Sarfati

Bachelot

Coussieu

et al. 2011

European Journal of Endocrinology

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Objective: Evaluation of postmenopausal women with suspicion of androgen-secreting tumor. Design and patients: We retrospectively studied 22 postmenopausal women referred to our center for suspicion of androgen-secreting tumor. All patients had clinical, biological, and morphological evaluation. In absence of adrenal tumors, ovarian surgery was most often proposed and immunohistochemistry (IHC) studies were performed. Results: Ovarian tumors were detected by ultrasound and/or magnetic resonance imaging in eight patients. Two adrenal androgen-secreting tumors were diagnosed by an adrenal computed tomography (CT) scan. The clinical presentation of the women with or without tumors was similar. Nevertheless, women with tumor exhibited significantly higher testosterone levels and lower basal FSH and LH levels than the other women (2.6G2.7 vs 0.9G0.9 ng/ml, P!0.05; 26.5G22.9 vs 66.5G 26.0 IU/l, P!0.01; and 12.0G8.6 vs 24.1G8.9 IU/l, P!0.05 respectively). Based on a likelihood ratio test, patients with a tumor had 8.4 and 10.8 times higher risk of having a testosterone level R1.4 ng/ml or an FSH level %35 IU/l. Finally, IHC analysis with an anti-P450c17a antibody allowed the identification of an elevated number of ovarian androgen-producing cells in five patients in whom no tumor was found. Conclusions: Androgen-secreting tumors are clinically difficult to discriminate from other causes of postmenopausal hyperandrogenism. Testosterone and FSH were the two discriminative markers in a multivariate analysis. Ovarian and adrenal tumors were detected by imaging studies. However, ovarian non-tumoral causes of hyperandrogenism may be difficult to detect with conventional histology.

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“…Most commonly, the affected ovaries are slightly enlarged and show a homogeneous stromal pattern. 8,9 Ovarian hyperthecosis is possible in this patient, because of ultrasound and hormone levels. After detailed consultation with the treating internist, a hormone therapy under fixed controls was initiated ( Table 2).…”

Section: Case Reportmentioning

confidence: 89%

Treatment of Hirsutism in a Woman With Familial Partial Lipodystrophy of Dunnigan Type

Foth¹,

Rahimi²

2010

The Endocrinologist

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Lipodystrophies are rare disorders. Familial partial lipodystrophy of the Dunnigan type (FPLD) is characterized by loss of subcutaneous fat from the limbs and trunk. Affected patients are insulin-resistant and may develop glucose intolerance and diabetes mellitus, hypertriglyceridemia, and low levels of high-density lipoprotein cholesterol. In these patients, the prevalence of polycystic ovaries and infertility is higher than in the general population. Besides infertility, clinical signs of hyperandrogenism can be of great importance for affected women. We report a case of a 32-year-old woman with FPLD. The patient suffered from severe hirsutism. Hormone serum measurements showed an elevated testosterone. After detailed consultation with the treating internist, antiandrogenic hormone therapy was initiated. The article summarizes the possibilities, problems, and results of antiandrogenic therapy in a patient with FPLD.

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Ovarian hyperthecosis on grayscale and color Doppler ultrasound

Abstract: Objectives

Cited by 37 publications

References 23 publications

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Impact of clinical, hormonal, radiological, and immunohistochemical studies on the diagnosis of postmenopausal hyperandrogenism

Treatment of Hirsutism in a Woman With Familial Partial Lipodystrophy of Dunnigan Type

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