Maternal luteoma of pregnancy presenting with virilization of the female infant.

Abstract

BACKGROUND:

Virilization in female newborns typically results from congenital adrenal hyperplasia, requiring immediate diagnosis and treatment. We report a rare cause of virilization, maternal pregnancy luteoma, responsible for virilization of both a newborn and the mother. Luteomas are usually asymptomatic tumour-like ovarian lesions of pregnancy that secrete androgens in only 25% of cases. Many female infants born to masculinized mothers will also be virilized.

CASE:

A term infant born with ambiguous genitalia was transferred to a referral centre for investigation, diagnosis, and treatment. Assessment identified Prader II-III genitalia, an elevated serum testosterone level, a normal serum 17-hydroxyprogesterone level, and a normal female karyotype (46,XX). The mother had had virilization from the second trimester and was found to have an elevated serum testosterone level. Pelvic ultrasound assessment in the mother showed a complex right ovarian mass. Laparotomy was performed, and the mass was excised. Histopathology examination confirmed a luteoma.

CONCLUSION:

High maternal serum testosterone levels due to a luteoma can result in virilization in the female newborn. This report emphasizes the need to consider possible underlying maternal pathology in evaluating a virilized female infant.

• Authors: Rachel F Spitzer, Diane Wherrett, David Chitayat, Terence Colgan, Jason Esli Dodge, Joao Luiz Pippi Salle, Lisa Allen
• Journal: Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (J Obstet Gynaecol Can) Vol. 29 Issue 10 Pg. 835-40 (Oct 2007) ISSN: 1701-2163 [Print] Netherlands
• PMID: 17915067 (Publication Type: Case Reports, Journal Article)

Chemical References

• Testosterone

Topics

• Adult
• Female
• Humans
• Infant, Newborn
• Luteoma (blood, diagnosis)
• Ovarian Neoplasms (blood, diagnosis)
• Pregnancy
• Pregnancy Complications, Neoplastic (diagnosis)
• Testosterone (blood)
• Virilism (blood)