Plasma Androgens in the Normal and Androgenic Female

Osborn, Robert H.; Yannone, Michael E.

doi:10.1097/00006254-197103000-00001

Cited by 52 publications

(13 citation statements)

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“…First, there was excessive androgen production of adrenal origin, yet the urinary 17-KS were within the normal range. Most reported cases of androgen-secreting adrenocortical adenomas have been associated with elevated urinary 17-KS because DHA or its sulphate conjugate is commonly secreted in excessive amounts by these tumors (9). The tumor of our patient was secreting testosterone which is so potent an androgen that a virilizing amount may not increase the 17-KS above the normal range.…”

Section: Discussionmentioning

confidence: 54%

“…This cell-type forms the brown line between these two zones which is observable on gross examination of the cut surface of the normal adrenal cortex (15). The cells of the zona reticularis secrete principally DHA which is the steroid frequently produced by virilizing adrenal adenomas (9). Instead of DHA, our patient's tumor secreted T; and with hCG stimulation, also produced A.…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

A Gonadotropin-Responsive Adrenocortical Adenoma

Givens¹,

Andersen²,

Wiser³

et al. 1974

The Journal of Clinical Endocrinology & Metabolism

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A 49-yr-old virilized woman had a peripheral plasma testosterone (T) concentration of 783-911 ng/100 ml with a normal plasma concentration of androstenedione (A) and normal urinary 17-ketosteroids (17-KS). Plasma LH was below normal and FSH was low normal. Plasma T was not changed by dexamethasone 2 mg/day and the 17-KS were not normally suppressible. The administration of 5,000 units of human chorionic gonadotropin (hCG) increased plasma T to 3,744 ng/100 ml and also increased A and the 17-KS. Based on these results an ovarian source of T was suspected and bilateral oophorectomy was performed. Bilateral ovarian cortical stromal hyperplasia was found. Removal of both ovaries did not correct the hypertestosteronemia.Because an adrenal lesion was suspected, an 8-hr ACTH infusion test was done. Plasma T was decreased 42% and LH 3 1 % at the sixth hour of the ACTH infusion. Plasma T was again increased by hCG to 2,379 ng/100 ml after the ovaries were removed. Both adrenals were explored and a 4 cm X 3 cm X 2 cm brown adrenocortical adenoma weighing 21 g was removed from the right adrenal. Plasma T was 17 ng/100 ml after the removal of the tumor and was now not increased by hCG. This gonadotropin-responsive adrenal adenoma further emphasizes that the results of hormonal manipulative procedures may be misleading in determining the source of excess androgen production. (/ Clin Endocrinol Metab 38: 126, 1974)

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 67%

A Gonadotropin-Responsive Adrenocortical Adenoma

Givens¹,

Andersen²,

Wiser³

et al. 1974

The Journal of Clinical Endocrinology & Metabolism

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“…As with other types of ovarian tumors, the patient can present with pain or abdominal distention due to the presence of a space-occupying lesion [3]. However, in contrast to other types ovarian tumors (epithelial or germ-cell), SLCTs may present with clinical signs and symptoms related to excess androgen production such as virilization [4]. Such manifestations include: progressive hirsutism, deepening of voice, male pattern scalp hair recession, increased musculature, and clitoromegaly.…”

Section: Introductionmentioning

confidence: 99%

Sertoli-Leydig cell tumor with unique nail findings in a post-menopausal woman: a case report and literature review

et al. 2014

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Background: Sertoli-Leydig cell tumor (SLCT) is a rare sex-cord tumor that usually occurs unilaterally and accounts for < 0.5% of all ovarian tumors. SLCT is uncommon in post-menopausal women, with the average age of diagnosis being 25 years. Case: We present a case of a 63-year-old post-menopausal woman presenting with progressive hirsutism, and male-pattern baldness. Unusual nail changes were also observed. Methods: Hormonal profile of the patient revealed increased testosterone and estradiol levels, and a 3.5 cm left ovarian mass. The patient was evaluated and was not found to be anemic or iron-deficient. Intraoperative frozen section assessment during laparoscopic exploration revealed SLCT, which was confirmed subsequently by histopathological and immunohistochemical (IHC) examination. Nail bed tissues were collected from normal females and evaluated by IHC for the presence of androgen receptors (AR).

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“…They are usually unilateral and confined to the ovary at the time of diagnosis. Approximately 80 % of SLCT are hormonally active with elevated serum testosterone and androstenedione levels and one third of these tumors is discovered due to the clinical signs and symptoms of excess androgen production (virilization, voice deepening, male pattern baldness, amenorrhea, clitoromegaly) [3]. Occasionaly patients have estrogenic manifestations (menometrorrhagia, postmenopausal bleeding) [4].…”

Section: Introductionmentioning

confidence: 99%

Sertoli - Leydig cell tumor with retiform areas and overgrowth of rhabdomyosarcomatous elements: case report and literature review

2016

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BackgroundSertoli - Leydig cell tumors (SLCTs) are sex-cord stromal tumors that account less than 0.5 % of primary ovarian neoplasms. They are mostly benign and occur in reproductive age women. Variants with heterologous mesenchymal elements are exceptionaly rare. The usual presentation of SLCTs is with signs of androgen excess as majority of them produce androgens.Case presentationWe present a case of a SLCT occurring in a 70 year old woman. Her presenting complaint was abdominal distension and pain. She had no signs of androgen or estrogen excess. Transvaginal ultrasound (TVUS) and CT scan showed a multilocular adnexal tumor and level of CA 125 was raised. A complete cytoreduction was achieved with surgical procedure. Histopathological examination revealed moderately differentiated SLCT with retiform areas and owergrowth of heterologous component in form of embrional rhabdomyosarcoma (RMS). She returned 7 months after the surgery with a large abdominal mass, ascites, right- sided hydronephrosis and massive pulmonary embolism. Due to the widespread disease and her poor general condition, she received only palliative care. She died 15 days after the admission. No autopsy was performed.ConclusionsDue to the rarity of SLCTs, especially those with retiform areas and heterologous elements, their management remains challenging. There is no firm evidence that adjuvant chemotherapy is effective in improving survival in SLCTs with malignant heterologous elements. Further studies with a higher number of cases and a longer follow-up are needed to better predicting the prognosis and determine the role of chemotherapy in such cases.

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Plasma Androgens in the Normal and Androgenic Female

Cited by 52 publications

References 0 publications

A Gonadotropin-Responsive Adrenocortical Adenoma

A Gonadotropin-Responsive Adrenocortical Adenoma

Sertoli-Leydig cell tumor with unique nail findings in a post-menopausal woman: a case report and literature review

Sertoli - Leydig cell tumor with retiform areas and overgrowth of rhabdomyosarcomatous elements: case report and literature review

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