An Occult Leydig Cell Tumour in a Postmenopausal Woman Presenting with Alopecia and Hirsutism: A Case Report.

TouchREVIEWS in endocrinology Pub Date : 2021-04-01 Epub Date: 2021-04-28 DOI:10.17925/EE.2021.17.1.75
Shuann Shwana, Natasha Shrikrishnapalasuriyar, Win Yin, Monica Vij, Atul Kalhan
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引用次数: 1

Abstract

Progressive hirsutism and moderate to severe male-pattern balding in women requires exclusion of an adrenal or ovarian tumour, especially in the presence of significantly elevated androgen levels. We present the case of a 68-year-old woman who was referred to an endocrinology clinic with insidious onset excessive facial hair growth and loss of scalp hair. Her testosterone levels were significantly elevated at 13 nmol/L (normal range: 0.1-1.4 nmol/L), although dehydroepiandrosterone sulphate and 17-hydroxyprogesterone levels were normal, suggestive of an ovarian source of androgens. Repeated radiologic investigations, including pelvic ultrasound, and abdominal and pelvic computed tomography, could not identify the obvious source of androgens. Based on strong clinical suspicion of an ovarian tumour, she underwent an elective salpingo-oophorectomy, which detected an occult Leydig cell tumour on histopathological analysis. Post-operatively, her hyperandrogenic features significantly improved and testosterone levels normalized.

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隐蔽性间质细胞肿瘤在绝经后妇女表现为脱发和多毛:1例报告。
进行性多毛症和中度至重度男性型秃顶的女性需要排除肾上腺或卵巢肿瘤,特别是在雄激素水平显著升高的情况下。我们提出的情况下,68岁的妇女谁被转介到内分泌诊所与潜伏发作过多的面部毛发生长和头皮头发的损失。她的睾酮水平显著升高至13 nmol/L(正常范围:0.1-1.4 nmol/L),尽管硫酸脱氢表雄酮和17-羟孕酮水平正常,提示卵巢雄激素来源。反复的放射学检查,包括盆腔超声、腹部和盆腔计算机断层扫描,都不能确定雄激素的明显来源。基于强烈的临床怀疑卵巢肿瘤,她接受了选择性输卵管卵巢切除术,在组织病理学分析中发现了隐匿的间质细胞肿瘤。术后高雄激素特征明显改善,睾酮水平恢复正常。
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