Androgen Secreting Steroid Cell Tumor of the Ovary Represented with Postmenopasal Bleeding and Extensive Hirsutism
Introduction: Steroid cell tumors of the ovary present less than 0.1% of all ovarian tumors and belong in the group of sex cord-stromal tumors.
Case description: We present a case of 69-year-old woman investigated because of postmenopausal bleeding, a 5-year history of excessive hirsutism, baldness and acne. The evaluation revealed elevated serum testosterone, but ultrasound detected a 2 cm-mass of the left ovary. The patient underwent hysterectomy and bilateral adnexectomy. The histopathology diagnosis was steroid cell tumor, not otherwise specified. Postoperative chemotherapy was administered at the discretion of the radio-oncologist. At the last follow-up 48 months after surgery, the hirsutism was completely resolved, the serum testosterone was within the normal range and there was no evidence of recurrence.Conclusion: In adult patients with hirsutism and elevated serum testosterone a possibility of a presence of an ovarian steroid cell tumor should be considered. Surgery is the main treatment of such patients.
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Young RH, Shully RE. Steroid cell tumors of the ovary. In: Fox H, Wells M, editor. Obstetric & Gynecological Pathology. Spain, Churchill Livingstone, 2003. pp. 845-56.
Hayes MC, Scully RE. Ovarian steroid cell tumors [not otherwise specified]: a clinicopathological analysis of 63 cases. Am J Surg Pathol. 1987;11:835-45.
Scully RE, Young RH, Clement PB. Tumors of the Ovary, Mal-developed Gonads, Fallopian Tube, and Broad Ligament. Washington, DC: Armed Forces Institute of Pathology. Steroid cell tumors, 1996: pp. 227-38.
Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961; 21:1440-7.
Pugeat M, Mirakian P, Dutrieux-Berger N et al. Androgen-secreting ovarian neoplasm. In: Azziz R, Nestler JE, Dewailly D, eds. Androgen excess disorders in women. Philadelphia, New York: Lippincott-Raven, 1997:555â€“568.
Monteagudo A, Heller D, Husami N et al. Ovarian steroid cell tumors: sonographic characteristics. Ultrasound Obstet Gynecol. 1997; 10(4):282â€“288.
Young RH. Ovarian tumors other than those of surface epithelial-stromal type. Hum Pathol. 1991; 22(8):763-75.
Regnier C, Bennet A, Malet D et al. Intraoperative testosterone assay for virilizing ovarian tumor topographic assessment: report of a Leydig cell tumor of the ovary in a premenopausal woman with an adrenal incidentaloma. J Clin Endocrinol Metab. 2002; 87(7):3074-7.
Jones MW, Raj H, Dabbs DJ, Carter GJ. Immunohistochemical profile of steroid cell tumor of the ovary: A study of 14 cases and a review of the literature. Int J Gynecol Pathol. 2010; 29(4):315-20.
Saida T, Tanaka YO, Minami M. Steroid cell tumor of the ovary, not otherwise specified: CT and MR findings. AJR AJR Am J Roentgenol. 2007; 188(4): W393-4.
Rosenfield RL. Pilosebaceous physiology in relation to hirsutism and acne. J Clin Endocrinol Metab. 1986;15:341-62.
Khan CR, Flier JS, Bas RS et al. The syndromes of insulin resistance and acanthosis nigricans. Insulin-receptor disorders in man. N Engl J Med. 1976;294(14):739-45.
Goldman JM, Kapadia LJ. Virilization in a postmenopausal woman due to ovarian stromal hyperthecosis. Postgrad Med J. 1991;67(785):304-6.
Krug E, Berga SL. Postmenopausal hyperthecosis: functional dysregulation of androgenesis in climacteric ovary. Obstet Gynecol. 2002; 99(5 Pt 2):893-7.
Farber M, Madanes A, Oâ€™Briain DS et al. Asymmetric hyperthecosis ovarii. Obstet Gynecol. 1981;57(4):521-5.
Choudhary SV, Banode PJ, Bhake A et al. Hirsutism with virilization in a postmenopausal woman due to a rare ovarian steroid cell tumor. Indian J Dermatol Venereol Leprol. 2010; 76(2):216.
Nardo LG, Ray DW, Laing I et al. Ovarian Leydig cell tumor in a peri-menopausal woman with severe hyperandrogenism and virilization. Gynecol Endocrinol. 2005; 21(4):238-241.
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