Keywords
Postmenopause
Leydig Cell Tumor
Ovary
Virilism
Hirsutism
Alopecia
How to Cite
Abstract
Background: Androgen-producing ovarian tumors correspond to 0.1 - 0.8% of the causes of clinical hyperandrogenism in women. Leydig cell tumors represent 5 - 8% of ovarian tumors, they are usually benign and unilateral, 7 - 18% of the patients present hirsutism as the main symptom and are a cause of hyperandrogenism and virilization in postmenopausal women.
Purpose: To present a case of female virilization secondary to ovarian Leydig cell tumor, to guide the reader through a discussion of the different etiologies of hyperandrogenism in postmenopausal women, and to summarize in an algorithm the diagnostic approach in patients with hyperandrogenism.
Case presentation: We present the case of a postmenopausal woman with with a one-year history of hirsutism and androgenic alopecia, associated to significantly elevated levels of testosterone and a pelvic magnetic resonance imaging (MRI) reporting a mass in the right adnexal region. A bilateral salpingo-oophorectomy was performed, and the pathology exam reported a malignant Leydig cell tumor stage IA. After surgical resection, the biochemical hyperandrogenism resolved and the hirsutism and alopecia improved.
Discussion: We discuss the approach of a post-menopausal woman with hyperandrogenism following the diagnostic algorithm we created.
Conclusion: In rapidly developing hyperandrogenism it is important to investigate the different possibilities of diagnosis, keeping in mind that signs of rapidly developing hyperandrogenism should alert of an androgen-producing neoplasm.
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