Selective ovarian vein sampling can be crucial to localize a Leydig cell tumor: An unusual case in a postmenopausal woman

Maturitas ◽  
2008 ◽  
Vol 61 (3) ◽  
pp. 278-280 ◽  
Author(s):  
Mahmut Tuncay Ozgun ◽  
Cem Batukan ◽  
Cagdas Turkyilmaz ◽  
Mehmet Dolanbay ◽  
Ertugrul Mavili
Keyword(s):  
Postmenopausal Woman ◽  
Leydig Cell ◽  
Unusual Case ◽  
Leydig Cell Tumor ◽  
Cell Tumor ◽  
Ovarian Vein

scholarly journals Poorly Differentiated Ovarian Sertoli-Leydig Cell Tumor in a Postmenopausal Woman: Case Report

2016 ◽  
Vol 26 (2) ◽  
pp. 119-124
Author(s):  
Hamide SAYAR ◽  
Emel CANAZ ◽  
Perihan Özlem DOĞAN ◽  
Gürkan KIRAN ◽  
Derya GÜMÜRDÜLÜ
Keyword(s):  
Case Report ◽  
Postmenopausal Woman ◽  
Leydig Cell ◽  
Leydig Cell Tumor ◽  
Cell Tumor ◽  
Poorly Differentiated

scholarly journals 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

2002 ◽  
Vol 87 (7) ◽  
pp. 3074-3077 ◽  
Author(s):  
C. Regnier ◽  
A. Bennet ◽  
D. Malet ◽  
T. Guez ◽  
M. Plantavid ◽  
...  
Keyword(s):  
Leydig Cell ◽  
Histopathological Examination ◽  
Premenopausal Women ◽  
Adrenal Incidentaloma ◽  
Leydig Cell Tumor ◽  
Cell Tumor ◽  
Plasma Testosterone ◽  
Ovarian Vein ◽  
Additional Information ◽  
Automated Technique

Ovarian virilizing tumors are rare and can lead to assessment difficulties because of their small size. A 41-yr-old female was referred for evaluation of hirsutism that had increased within the previous 3 yr. Menstrual cycle length was normal. Plasma testosterone was 3.9 ng/ml (normal range, 0.2–0.8 ng/ml), was not suppressible by 2 mg dexamethasone (4.3 ng/ml), and was increased (6.3 ng/ml) after three daily injections of hCG (5000 IU). Abdominal computed tomography scan showed an adrenal nodule (13 × 6 mm) that remained unchanged after 3 months. Ultrasound examination of the pelvis was normal. Ovarian and adrenal venous catheterization did not yield additional information. Topographic assessment was made by intraoperative measurement of testosterone in the samples taken from each ovarian vein (competitive chemiluminescent immunoassay ADVIA Centaur; right ovarian vein, 105 ng/ml; left ovarian vein, 5 ng/ml; peripheral blood, 7 ng/ml). Right annexectomy resulted in normalization of testosterone levels (0.22 ng/ml). Histopathological examination found a Leydig cell tumor of hilar type (1.5 cm). This observation illustrates the usefulness of intraoperative measurement of testosterone by a rapid automated technique for topographic assessment of ovarian virilizing tumor in premenopausal women.

scholarly journals Diagnosis of Sertoli-Leydig Cell Tumor of the Ovary Complicated by the Pattern of Hyperandrogenemia and Results of Imaging

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A779-A780
Author(s):  
Amruta Jaju ◽  
Vanessa Williams ◽  
Mohammad Jamal Uddin Ansari ◽  
Mariam Murtaza Ali ◽  
Michael G Jakoby
Keyword(s):  
Postmenopausal Woman ◽  
Leydig Cell ◽  
Adnexal Mass ◽  
Dehydroepiandrosterone Sulfate ◽  
Leydig Cell Tumor ◽  
Cell Tumor ◽  
Total Testosterone ◽  
Well Differentiated ◽  
The Right ◽  
Ovarian Masses

Abstract Introduction: Virilization in a postmenopausal woman requires evaluation for an androgen-secreting tumor. The differential diagnosis includes adrenal carcinomas and adenomas and Sertoli-Leydig cell tumors, granulosa-theca cell tumors, and hilus-cell tumors of the ovaries. We present a case of virilization in a postmenopausal woman caused by a Sertoli-Leydig cell tumor (SLCT) in which evaluation was complicated by the pattern of androgen elevation, bilateral adrenal nodules, and absence of an adnexal mass. Case: A 64-year-old female was referred for evaluation of hyperandrogenism. Hirsutism, temporal hairline regression, and unusually deep voice were noted on examination. Two total testosterone levels obtained one month apart were 146 ng/dL (2-45), and measurements of dehydroepiandrosterone sulfate (DHEAS) and androstenedione were 299 mcg/dL (12-133) and 1.84 ng/mL (0.130-0.820), respectively. Abdominal CT revealed bilateral adrenal nodules - 2 cm and - 5 Hounsfield units (HU) on the left, and 1.5 cm and 5 HU on the right - but no ovarian masses. Transvaginal ultrasonography also failed to identify a discrete ovarian mass but showed endometrial hyperplasia. Virilization, magnitude of testosterone elevation, and results of imaging were felt to be most strongly indicative of ovarian hyperthecosis, and the patient underwent laparoscopic bilateral salpingo-oophorectomy and hysterectomy. The right ovary was 2.3 cm in largest diameter and approximately 90% replaced by an orange-red mass that showed Sertoli and Leydig cells on microscopy, immunohistochemical staining for the sex cord proteins inhibin and calretinin, and presence of the Leydig cell marker melan A. It was classified as well differentiated. Additional CT imaging and robotic assisted laparoscopy confirmed a stage IA tumor. One month after surgery, hyperandrogenemia had completely resolved (total testosterone < 10 ng/dL, androstenedione 0.379 ng/mL, and DHEAS 99 mcg/dL), and changes of virilization had mostly regressed at an eight months appointment. Discussion: SLCTs are a type of sex-cord stromal ovarian tumor. They constitute < 0.5% of ovarian tumors but account for approximately 75% of testosterone-secreting ovarian masses. This patient’s case was unusual for multiple reasons: 1. Age - most SLCTs are diagnosed in the second or third decade, 2. Imaging - CT and ultrasonography usually show a solid or solid and cystic adnexal mass, and co-existing adrenal nodules are rare, likely due to typical young age of presentation, and 3. Pattern of androgen elevation - DHEAS was more than two-fold elevated, and usually < 10% of DHEA and DHEAS are produced by the ovaries. However, DHEAS fell significantly after oophorectomy. SLCTs are a potential etiology of virilization in postmenopausal women even in the absence of a detectable adnexal mass and when biochemistries and imaging raise the possibility of an adrenal source of androgen.

Ovarian Hyperthecosis and Stromal Leydig Cell Tumor in a Postmenopausal Woman With Virilization

2009 ◽  
Vol 19 (6) ◽  
pp. 298-301 ◽  
Author(s):  
Shalini Vijaykumar ◽  
Abhay Srinivasan ◽  
Violeta Botea Popii
Keyword(s):  
Postmenopausal Woman ◽  
Leydig Cell ◽  
Leydig Cell Tumor ◽  
Cell Tumor

A case of Sertoli-Leydig cell tumor in a postmenopausal woman

2006 ◽  
Vol 16 (1) ◽  
pp. 435-438 ◽  
Author(s):  
A. CARINGELLA ◽  
V. LOIZZI ◽  
L. RESTA ◽  
R. FERRERI ◽  
G. LOVERRO
Keyword(s):  
Postmenopausal Woman ◽  
Leydig Cell ◽  
Leydig Cell Tumor ◽  
Cell Tumor
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