Abstract |
A 49-year-old woman presented with rapidly progressing hirsutism, receding hairline, male-pattern baldness and deepening of voice, which had developed over the past 2 years. Hormonal evaluation showed a markedly elevated serum testosterone level (418 ng/dl) and no evidence of increased production of cortisol, dehydroepiandrosterone, dehydroepiadrosterone- sulfate, androstenedione, or 17-hydroxyprogesterone. Transvaginal ultrasound examination suggested the presence of a small mass within the left ovary, but all other radiological studies, including adrenal and ovarian computed tomography, magnetic resonance imaging, radio-labelled cholesterol scintigraphy and positron emission tomography, were negative. Subsequently, bilateral selective venous sampling showed a marked testosterone gradient in the right ovarian vein. Bilateral salpingo-oophorectomy was performed (the patient had had a previous vaginal hysterectomy), and histopathological examination revealed a 10-mm steroid cell tumor within the right ovary and a 15-mm thecal cell tumor within the left ovary. The postoperative serum testosterone level returned to normal and the patient showed a slow regression of clinical symptoms. The simultaneous occurrence of a virilizing ovarian steroid cell tumor and an apparently non-functioning thecoma within the contralateral ovary emphasizes the potential pitfalls that may exist in the preoperative evaluation of patients with markedly increased testosterone production.
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Authors | E Cserepes, N Szücs, P Patkós, Z Csapó, F Molnár, M Tóth, G Dabasi, O Esik, K Rácz |
Journal | Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
(Gynecol Endocrinol)
Vol. 16
Issue 3
Pg. 213-6
(Jun 2002)
ISSN: 0951-3590 [Print] England |
PMID | 12192893
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Alopecia
(etiology, pathology)
- Diagnosis, Differential
- Female
- Humans
- Hyperandrogenism
(etiology, pathology)
- Leydig Cell Tumor
(complications, diagnosis, pathology, surgery)
- Middle Aged
- Neoplasms, Multiple Primary
(complications, diagnosis, pathology, surgery)
- Ovarian Neoplasms
(complications, diagnosis, pathology, surgery)
- Ovariectomy
- Salpingostomy
- Testosterone
(blood)
- Thecoma
(complications, diagnosis, pathology, surgery)
- Virilism
(etiology, pathology)
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