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Aljenaee K, Ali S, Cheah SK, et al. Marked hyperandrogenicity in a 60-year-old woman. Endocrinol Diabetes Metab Case Rep. 2017;2017doi: 10.1530/EDM-17-0075.
Aljenaee, K., Ali, S., Cheah, S. K., MacEneaney, O., Mulligan, N., Hickey, N., Tun, T. K., Sreenan, S., & McDermott, J. H. (2017). Marked hyperandrogenicity in a 60-year-old woman. Endocrinology, diabetes & metabolism case reports, 2017. https://doi.org/10.1530/EDM-17-0075
Aljenaee, Khaled, et al. "Marked hyperandrogenicity in a 60-year-old woman." Endocrinology, diabetes & metabolism case reports vol. 2017 (2017). doi: https://doi.org/10.1530/EDM-17-0075
Aljenaee K, Ali S, Cheah SK, MacEneaney O, Mulligan N, Hickey N, Tun TK, Sreenan S, McDermott JH. Marked hyperandrogenicity in a 60-year-old woman. Endocrinol Diabetes Metab Case Rep. 2017 Sep 04;2017. doi: 10.1530/EDM-17-0075. eCollection 2017. PMID: 28924479; PMCID: PMC5592702.
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Endocrinol Diabetes Metab Case Rep. 2017 Sep 04;2017. doi: 10.1530/EDM-17-0075. eCollection 2017.

Marked hyperandrogenicity in a 60-year-old woman.

Endocrinology, diabetes & metabolism case reports

Khaled Aljenaee, Sulaiman Ali, Seong Keat Cheah, Owen MacEneaney, Niall Mulligan, Neil Hickey, Tommy Kyaw Tun, Seamus Sreenan, John H McDermott

Affiliations

  1. Department of Endocrinology, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, Ireland.
  2. Departments of Endocrinology.
  3. Histopathology, Mater Misericordiae University Hospital, Dublin, Ireland.
  4. Department of Radiology, Connolly Hospital Blanchardstown, Dublin, Ireland.

PMID: 28924479 PMCID: PMC5592702 DOI: 10.1530/EDM-17-0075

Abstract

Markedly elevated androgen levels can lead to clinical virilization in females. Clinical features of virilization in a female patient, in association with biochemical hyperandrogenism, should prompt a search for an androgen-producing tumor, especially of ovarian or adrenal origin. We herein report the case of a 60-year-old woman of Pakistani origin who presented with the incidental finding of male pattern baldness and hirsutism. Her serum testosterone level was markedly elevated at 21 nmol/L (normal range: 0.4-1.7 nmol/L), while her DHEAS level was normal, indicating a likely ovarian source of her elevated testosterone. Subsequently, a CT abdomen-pelvis was performed, which revealed a bulky right ovary, confirmed on MRI of the pelvis as an enlarged right ovary, measuring 2.9 × 2.2 cm transaxially. A laparoscopic bilateral salpingo-oophorectomy was performed, and histopathological examination and immunohistochemistry confirmed the diagnosis of a Leydig cell tumor, a rare tumor accounting for 0.1% of ovarian tumors. Surgical resection led to normalization of testosterone levels.

LEARNING POINTS: Hirsutism in postmenopausal women should trigger suspicion of androgen-secreting tumorExtremely elevated testosterone level plus normal DHEAS level point toward ovarian sourceLeydig cell tumor is extremely rare cause of hyperandrogenicity.

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