Short Term Administration of Gonadotropin-Releasing Hormone Analog to a Patient with a Testosterone-Secreting Ovarian Tumor

Kennedy, Laurence; Ai, Traub; Atkinson, A. B.; Sheridan, B.

doi:10.1210/jcem-64-6-1320

Cited by 32 publications

(8 citation statements)

References 23 publications

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“…A suppressive effect of GnRH analogues on testosterone secretion by different types of ovarian tumours has been described. To our knowledge, four patients with Leydig cell tumours (1,(3)(4)(5), one with stromal luteoma (2), one with granulosa cell tumour (4) and one with hilus cell tumour (4) have been reported. In four cases the tumour was 1 cm in size and five cases were postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

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Use of a long-acting gonadotrophin-releasing hormone analogue in a postmenopausal woman with hyperandrogenism due to a hilus cell tumour

Picon

Lara²,

Sarasa³

et al. 2000

European Journal of Endocrinology

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Objective: The aim of this study was to prove the utility of GnRH analogues for the suppression of androgen secretion in a postmenopausal woman with a suspected virilizing ovarian tumour. Design and Methods:We present a case of a 72-year-old woman with virilization of recent onset. Hormonal studies revealed a fourfold increase in serum testosterone levels, normal dehydroepiandrosterone sulphate concentrations and high levels of serum 17-hydroxyprogesterone levels. Computed axial tomography scan of the ovaries was normal and the adrenal glands showed a discrete enlargement. The long-acting GnRH analogue, triptorelin, was injected initially (3.75 mg i.m.) and serum hormone levels were measured weekly throughout one month. Results: GnRH produced a decrease in serum testosterone levels to normal values, in parallel with the suppression of serum LH and FSH concentrations. The patient was treated for three months with triptorelin and she experienced an amelioration of the hyperandrogenic symptoms. In order to achieve a diagnosis, the patient was submitted to a laparotomy that revealed a small hilus cell tumour in the left ovary. Conclusion: GnRH analogues may offer a good therapeutic option in some states of gonadotrophindependent hyperandrogenism of ovarian origin.

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Section: Discussionmentioning

confidence: 99%

“…In four cases the tumour was 1 cm in size and five cases were postmenopausal women. Testosterone levels were reduced by 50% in two patients treated with short-acting GnRH analogues, whereas a decrease to normal values was seen in the remaining patients treated with long-acting analogues (1)(2)(3)(4)(5).…”

Section: Discussionmentioning

confidence: 99%

Use of a long-acting gonadotrophin-releasing hormone analogue in a postmenopausal woman with hyperandrogenism due to a hilus cell tumour

Picon

Lara²,

Sarasa³

et al. 2000

European Journal of Endocrinology

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“…We are aware of one report of a Leydig cell tumor in a postmenopausal woman who was treated with the GnRHa buserelin for 16 days, resulting in a 50% decrease in testosterone before undergoing surgery (21). Depot leuprolide injections were successful in suppressing plasma testosterone and relieving symptoms in our patient for 16 months.…”

Section: Discussionmentioning

confidence: 66%

Long-Term Suppression of Testosterone After Treatment with a Gonadotropin-Releasing Hormone Agonist in a Woman with a Presumed Testosterone Secreting Ovarian Tumor

Barnes¹,

Ehrmann

1997

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Between 1 in 300 and 1 in 1000 patients who present with hirsutism will be diagnosed with an ovarian androgen secreting tumor, which in turn account for <0.5% of all ovarian tumors [1, 10]. These rare tumors include histologies such as Leydig cell [2, 3, 5, 7, 8, 10], Brenner [4, 9], and granulosa cell tumors [6]. In addition to tumorous sources, which often present acutely, hyperandrogenism can be the result of several non-tumorous ovarian pathologies, which are more likely to present with progressive signs and symptoms of elevated androgen levels.…”

Section: Discussionmentioning

confidence: 99%

Hyperandrogenism in menopause: a case report and literature review

Dolinko

Ginsburg

2015

Fertil Res and Pract

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Hyperandrogenism is an uncommon diagnosis in postmenopausal women. In this case, we report on a 69-year-old postmenopausal woman who presented with several months of worsening hirsutism of the face, neck, and chin, which was confirmed on examination. Laboratory testing revealed markedly elevated testosterone levels and typical post-menopausal gonadotropin levels. Transvaginal ultrasonography and pelvic and abdominal magnetic resonance imaging (MRI) failed to reveal an ovarian or adrenal abnormality. The patient was a poor surgical candidate and was counseled to start on gonadotropin releasing hormone (GnRH) agonist therapy. Administration of leuprolide resulted in a dramatic decline in testosterone levels. The patient reported significant “hot flashes”, difficulty sleeping, anxiety, and depression secondary to treatment, and patient discontinued leuprolide therapy 3 months after initiation. To our knowledge, this is the first case that describes a woman being treated with a GnRH agonist for hyperandrogenism subsequently discontinuing GnRH agonist treatment due to significant side-effects. This case also highlights the difficulty of prescribing appropriate but off-label use of expensive medications not covered by insurance in a senior population of limited income.

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Short Term Administration of Gonadotropin-Releasing Hormone Analog to a Patient with a Testosterone-Secreting Ovarian Tumor

Cited by 32 publications

References 23 publications

Use of a long-acting gonadotrophin-releasing hormone analogue in a postmenopausal woman with hyperandrogenism due to a hilus cell tumour

Use of a long-acting gonadotrophin-releasing hormone analogue in a postmenopausal woman with hyperandrogenism due to a hilus cell tumour

Long-Term Suppression of Testosterone After Treatment with a Gonadotropin-Releasing Hormone Agonist in a Woman with a Presumed Testosterone Secreting Ovarian Tumor

Hyperandrogenism in menopause: a case report and literature review

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