Ovarian Stromal Tumors: A Rare Cause of Postmenopausal Virilization
AbstractWe report the case of a 61-year-old Filipino woman with postmenopausal virilization presenting with androgenic alopecia, progressive hirsutism and deepening voice over 5 years due to elevated testosterone levels. Ultrasound and computed tomography imaging suggested a left adnexal mass. Histology obtained following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) demonstrated stromal luteoma of the left ovary. On immunohistochemistry, the tumor was positive for inhibin. Postoperatively, there was note of rapid normalization of testosterone level.
Tavassoli FA, Devilee PE, eds. World Health Organization classification of tumours. Pathology and genetics of tumours of the breast and female genital organs. Lyon: IARC Press, 2003.
Hayes MC, Scully RE. Stromal luteoma of the ovary: A clinicopathological analysis of 25 cases. Int J Gynecol Pathol 1987;6(4):313-21.
Young RH, Scully RE. Sex cord-stromal, steroid cell, and other ovarian tumours with endocrine, paraendocrine and paraneoplastic manifestations. In: Kurman RJ, ed. Blaustein’s pathology of the female genital tract, 5th ed. New York: Springer-Verlag, 2002.
Roth LM. Recent advances in the pathology and classification of ovarian sex cord-stromal tumors. Int J Gynecol Pathol 2006;25(3):199-215.
Paraskevas M, Scully RE. Hilus cell tumor of the ovary. A clinicopathological analysis of 12 Reinke crystal-positive and nine crystal-negative cases. Int J Gynecol Pathol 1989;8(4):299-310.
Scully RE. Stromal luteoma of the ovary. A distinctive type of lipoid-cell tumor. Cancer 1964;17:769-78.
Dhingra KK, Sharma P, Khurana N et al. Ovarian stromal luteoma in a patient with endometrial carcinoma. J Obstet Gynaecol Res 2008;34(2):283-5.
Reedy MB, Richards WE, Ueland F et al. Ovarian steroid cell tumors, not otherwise specified: A case report and literature review. Gynecol Oncol 1999;75(2):293-7.
Stephens JW, Katz JR, McDermott N et al. An unusual steroid-producing ovarian tumour: Case report. Hum Reprod 2002;17(6):1468-71.
Chico A, García JL, Matías-Guiu X et al. A gonadotrophin dependent stromal luteoma: A rare cause of postmenopausal virilization. Clin Endocrinol (Oxf) 1995;43(5):645-9.
Animas RM. Luteoma of pregnancy. Philippine Journal of Reproductive Endocrinology and Infertility. 2009;6. http://psrei.org/?page_id=406
Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 24-1993. N Engl Med 1993;328(24):1770-6.
Martin KA, Chang RJ, Ehrmann DA et al. Evaluation and treatment of hirsutism in premenopausal women: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2008;93(4):1105-20.
Waggoner W, Boots LR, Azziz R. Total testosterone and DHEAS levels as predictors of androgen-secreting neoplasms: A populational study. Gynecol Endocrinol 1999;139(6):394-400.
Kaltsas GA, Isidori AM, Kola BP et al. The value of the low-dose dexamethasone suppression test in the differential diagnosis of hyperandrogenism in women. J Clin Endocrinol Metab 2003;88(6):2634-43.
Cordera F, Grant C, van Heerden J et al. Androgen-secreting adrenal tumors. Surgery 2003;134(6):874-80.
Wild RA, Carmina E, Diamanti-Kandarakis E et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: A consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab 2010;95(5):2038-49.
Rothman MS, Wierman ME. How should postmenopausal androgen excess be evaluated? Clin Endocrinol (Oxf) 2011;75(2):160-4.
Dorgan JF, Stanczyk FZ, Kahle LL et al. Prospective case-control study of premenopausal serum estradiol and testosterone levels and breast cancer risk. Breast Cancer Res 2010;12(6):R98.
Shaw LJ, Bairey Merz CN, Azziz R et al. Postmenopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: Results from the National Institutes of Health—National Heart, Lung, and Blood Institute sponsored Women’s Ischemia Syndrome Evaluation. J Clin Endocrinol Metab 2008;93(4):1276-84.
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