Discriminating between virilizing ovary tumors and ovary hyperthecosis in postmenopausal women: clinical data, hormonal profiles and image studies

Autor: Sorahia Domenice, Ana Flavia Assis Avila, Michelle Patrocíneo Rocha, Sylvia Asaka Yamashita Hayashida, Ronaldo Hueb Baroni, Filomena Marino Carvalho, Cristiano Roberto Grimaldi Barcellos, Berenice B. Mendonca, Wagner S Dantas, Viviane dos Reis Vieira Yance, José Antonio Miguel Marcondes
Rok vydání: 2017
Předmět:
Endocrinology
Diabetes and Metabolism
Physiology
Cohort Studies
0302 clinical medicine
Endocrinology
Thecoma
Ovarian Stromal Hyperthecosis
Prevalence
Testosterone
Ultrasonography
Ovarian Neoplasms
030219 obstetrics & reproductive medicine
Estradiol
General Medicine
Organ Size
Middle Aged
Magnetic Resonance Imaging
Tumor Burden
Up-Regulation
Postmenopause
medicine.anatomical_structure
Female
Follicle Stimulating Hormone
Human
medicine.medical_specialty
medicine.drug_class
Down-Regulation
030209 endocrinology & metabolism
Ovary
Diagnosis
Differential
03 medical and health sciences
Internal medicine
medicine
Humans
Aged
Retrospective Studies
Hyperplasia
business.industry
Hyperthecosis
Hyperandrogenism
Luteinizing Hormone
medicine.disease
Androgen
Differential diagnosis
business
Precancerous Conditions
Follow-Up Studies
Zdroj: European journal of endocrinology. 177(1)
ISSN: 1479-683X
Popis: Background The presence of virilizing signs associated with high serum androgen levels in postmenopausal women is rare. Virilizing ovarian tumors (VOTs) and ovarian stromal hyperthecosis (OH) are the most common etiologies in virilized postmenopausal women. The differential diagnosis between these two conditions is often difficult. Objective To evaluate the contribution of clinical features, hormonal profiles and radiological studies to the differential diagnosis of VOT and OH. Design A retrospective study. Setting A tertiary center. Main outcome measures Clinical data, hormonal status (T, E2, LH and FSH), pelvic images (transvaginal sonography and MRI) and anatomopathology were reviewed. Patients Thirty-four postmenopausal women with a diagnosis of VOT (13 women) and OH (21 women) were evaluated retrospectively. Results Clinical signs of hyperandrogenism were more prevalent in the VOT group than the OH group. Although the VOT group showed higher T and E2 levels and lower gonadotropin levels than the OH group, a great overlap occurred among the hormone levels. A pelvic MRI provided an accurate differentiation of these two conditions. Conclusion In this group of patients, the main features contributing to the differential diagnosis of VOT and OH were serum levels of testosterone and gonadotropins and the presence of an ovarian nodule identified on the MRI. Although the association of clinical, hormonal and radiological features contributes to the differential diagnosis of these two conditions, histopathological analysis remains the gold standard for the diagnosis of ovarian hyperandrogenism in postmenopausal women.
Databáze: OpenAIRE
Externí odkaz: