Ovarian intratumoral 21-hydroxylase deficiency in a postmenopausal hirsute woman.

Abstract

Virilising ovarian tumours are a rare cause of hyperandrogenism in women, accounting for less than 5% of all ovarian neoplasms. It occurs most often in - and postmenopausal women. We report a case of a 64 year-old woman with signs of virilisation that had started 3 years before. Blood hormone analysis revealed increased levels of testosterone, and 17-hydroxyprogesterone. The tetracosactin test revealed 21-hydroxylase deficiency. Radiological imaging demonstrated a nodule in her left ovary. The patient was submitted to bilateral laparoscopic oophorectomy, and histopathological examination revealed a luteoma of the left ovary. Postoperative serum testosterone level and 17-hydroxyprogesterone returned to normal levels in one month. Virilism regressed within six months. Our patient also showed an elevation in 17-OHP serum levels. Normalization of 17-OHP after oophorectomy suggests a case of intratumoral 21-hydroxylase deficiency. To our knowledge, this is the first description of ovarian intratumoral 21-hydroxylase deficiency in a postmenopausal woman.

• Authors: Selma B Souto, Pedro V Baptista, Filomena Barreto, Pedro F Sousa, Daniel C Braga, Davide Carvalho
• Journal: Arquivos brasileiros de endocrinologia e metabologia (Arq Bras Endocrinol Metabol) Vol. 56 Issue 9 Pg. 672-6 (Dec 2012) ISSN: 1677-9487 [Electronic] Brazil
• PMID: 23329192 (Publication Type: Case Reports, Journal Article)

Chemical References

• Cosyntropin
• Testosterone

Topics

• Adrenal Hyperplasia, Congenital (pathology)
• Cosyntropin
• Female
• Hirsutism (etiology, pathology)
• Humans
• Luteoma (complications, pathology)
• Middle Aged
• Ovarian Neoplasms (complications, pathology)
• Postmenopause
• Testosterone (blood)