Marked hyperandrogenicity in a 60-year-old woman

[摘要] Markedly elevated androgen levels can lead to clinical virilization in females. Clinical features of virilization in a femalepatient, in association with biochemical hyperandrogenism, should prompt a search for an androgen-producing tumor,especially of ovarian or adrenal origin. We herein report the case of a 60-year-old woman of Pakistani origin whopresented with the incidental finding of male pattern baldness and hirsutism. Her serum testosterone level was markedlyelevated at 21nmol/L (normal range: 0.4–1.7nmol/L), while her DHEAS level was normal, indicating a likely ovarian sourceof her elevated testosterone. Subsequently, a CT abdomen-pelvis was performed, which revealed a bulky right ovary,confirmed on MRI of the pelvis as an enlarged right ovary, measuring 2.9×2.2cm transaxially. A laparoscopic bilateralsalpingo-oophorectomy was performed, and histopathological examination and immunohistochemistry confirmedthe diagnosis of a Leydig cell tumor, a rare tumor accounting for 0.1% of ovarian tumors. Surgical resection led tonormalization of testosterone levels.

[学科分类] 血液学