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An unusual hormone pattern in a virilized woman affected by Sertoli-Leydig cell tumor. Report of a case.

Abstract
A 24-year-old woman was admitted to hospital because of hirsutism, virilism and amenorrhea, which had appeared 6 months earlier. Endocrinological evaluation showed a slightly elevated serum level of testosterone (1.2 +/- 0.05 ng/ml), normal plasma levels of dehydroepiandrosteronesulfate (DHEA-S) (2,070 +/- 6 ng/ml), androstenedione (1.8 +/- 0.5 ng/ml) and sex hormone-binding globulin (SHBG)(42 +/- 3 nM/L); there was normal urinary 17-ketosteroid (17-KS) excretion (11.7 mg/24 h), low urinary estrogen (E) excretion (3 +/- 0.4 micrograms/24 h), suppressed basal gonadotropin concentrations (LH 0.9 microUI/ml; FSH 3.2 microUI/ml) and an exaggerated response to the LH-RH test. At laparotomy, a monolateral ovarian tumor was found, which was proved histologically to be a Sertoli-Leydig cell tumor. After tumor ablation, a regular menstrual cycle followed and progressive reduction of virilism was noted. This was followed within 4 months by complete normalization of LH, FSH, estrogen and progesterone serum levels. The responsiveness to LH-RH also became normalized. Two years after this operation, the patient had a normal pregnancy. This case of virilization in a woman affected by a benign Sertoli-Leydig cell tumor was primarily characterized by an unusual response of the hypothalamopituitary axis against an endocrinological background of notable alteration of the androgen/estrogen ratio, where the androgens were slightly increased and the estrogens greatly reduced.
AuthorsM A Satta, G De Rosa, A Scoppola, C Rabitti, E Piccinno, F Monaco
JournalActa pathologica japonica (Acta Pathol Jpn) Vol. 39 Issue 11 Pg. 755-8 (Nov 1989) ISSN: 0001-6632 [Print] Australia
PMID2694756 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Hormones
  • Gonadotropin-Releasing Hormone
  • Testosterone
Topics
  • Adult
  • Female
  • Gonadotropin-Releasing Hormone
  • Hormones (blood)
  • Humans
  • Leydig Cell Tumor (blood, complications, pathology)
  • Ovarian Neoplasms (blood, complications, pathology)
  • Sertoli Cell Tumor (blood, complications, pathology)
  • Testosterone (blood)
  • Virilism (blood, etiology)

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