Low leptin level in an obese hyperandrogenic woman--potential marker for androgen-secreting tumor.

Abstract

Hyperandrogenism in postmenopausal women is due to ovarian hyperthecosis or an androgen-secreting ovarian/adrenal tumor. Making the correct diagnosis might be complicated due to the possible existence of an adrenal neoplasm secreting testosterone only, ectopic ovarian tissue or ectopic luteinizing hormone/human chorionic gonadotropin receptors in the adrenals, as well as the relatively low sensitivity of imaging techniques (computed tomography, magnetic resonance imaging) and vein catheterization for this type of pathology. We present the case of an obese postmenopausal woman with metabolic syndrome, hyperandrogenism (high testosterone levels, suppressed gonadotropins), adrenal macronodular hyperplasia and Leydig-cell ovarian tumor. At presentation she had low leptin levels despite high body fat content. After a catheter study left adrenalectomy was carried out but hyperandrogenism persisted. Then, bilateral oophorectomy with hysterectomy was performed and a small Leydig-cell tumor was found in the left ovary. Postoperatively, testosterone and gonadotropin levels were normal (postmenopausal) and leptin level became elevated without change in body mass index or body fat content. In conclusion, we speculate that low leptin levels in obese hyperandrogenic women might be a marker for androgen-secreting tumors.

• Authors: Goran Cvijovic, Sylvia A Y Yamashita, Dragan Micic, Aleksandra Kendereski, Mirjana Sumarac-Dumanovic, Svetlana Zoric, Vera Popovic
• Journal: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology (Gynecol Endocrinol) Vol. 23 Issue 2 Pg. 112-6 (Feb 2007) ISSN: 0951-3590 [Print] England
• PMID: 17454162 (Publication Type: Case Reports, Journal Article)

Chemical References

• Biomarkers
• Leptin

Topics

• Adrenal Glands (pathology)
• Alopecia (etiology)
• Biomarkers (blood, metabolism)
• Female
• Hirsutism (etiology)
• Humans
• Hyperandrogenism (etiology)
• Hyperplasia (complications)
• Leptin (blood, metabolism)
• Leydig Cell Tumor (complications, metabolism)
• Metabolic Syndrome (complications)
• Middle Aged
• Obesity
• Ovarian Neoplasms (complications, diagnosis, metabolism)