Marked hyperandrogenicity in a 60-year-old woman.

Autor:	Aljenaee K; Department of Endocrinology, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, Ireland., Ali S; Departments of Endocrinology., Cheah SK; Department of Endocrinology, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, Ireland., MacEneaney O; Histopathology, Mater Misericordiae University Hospital, Dublin, Ireland., Mulligan N; Histopathology, Mater Misericordiae University Hospital, Dublin, Ireland., Hickey N; Department of Radiology, Connolly Hospital Blanchardstown, Dublin, Ireland., Tun TK; Department of Endocrinology, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, Ireland., Sreenan S; Department of Endocrinology, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, Ireland., McDermott JH; Department of Endocrinology, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, Ireland.
Jazyk:	angličtina
Zdroj:	Endocrinology, diabetes & metabolism case reports [Endocrinol Diabetes Metab Case Rep] 2017 Sep 04; Vol. 2017. Date of Electronic Publication: 2017 Sep 04 (Print Publication: 2017).
DOI:	10.1530/EDM-17-0075
Abstrakt:	Markedly elevated androgen levels can lead to clinical virilization in females. Clinical features of virilization in a female patient, in association with biochemical hyperandrogenism, should prompt a search for an androgen-producing tumor, especially of ovarian or adrenal origin. We herein report the case of a 60-year-old woman of Pakistani origin who presented with the incidental finding of male pattern baldness and hirsutism. Her serum testosterone level was markedly elevated at 21 nmol/L (normal range: 0.4-1.7 nmol/L), while her DHEAS level was normal, indicating a likely ovarian source of her elevated testosterone. Subsequently, a CT abdomen-pelvis was performed, which revealed a bulky right ovary, confirmed on MRI of the pelvis as an enlarged right ovary, measuring 2.9 × 2.2 cm transaxially. A laparoscopic bilateral salpingo-oophorectomy was performed, and histopathological examination and immunohistochemistry confirmed the diagnosis of a Leydig cell tumor, a rare tumor accounting for 0.1% of ovarian tumors. Surgical resection led to normalization of testosterone levels. Learning Points: Hirsutism in postmenopausal women should trigger suspicion of androgen-secreting tumorExtremely elevated testosterone level plus normal DHEAS level point toward ovarian sourceLeydig cell tumor is extremely rare cause of hyperandrogenicity.
Databáze:	MEDLINE
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