Endocrine Abstracts

We present the case of a 50-year-old woman who presented with 12 months of amenorrhea associated with signs of virilisation. Investigations revealed markedly raised serum concentrations of testosterone (9 nmol/l), whereas sex hormone binding globulin, random cortisol, androstenedione, 17-hydroxyprogesterone and dehydroepiandrosterone sulphate concentrations were all within the normal range. Computed tomography scan of the pelvis and abdomen showed a slightly bulky right ovary, and there left ovarian mass. An ovarian source of androgens was suspected. The testosterone level failed to suppress after an overnight dexamethasone suppression test and this support ovarian source of androgen. Surgery was arranged and she underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological examination revealed a Leydig cell tumour within the left ovary. Hyperandrogenaemia normalized post-operatively. The patient showed significant regression of clinical signs and symptoms, including the anxiety disorder.

Conclusion: The present case confirms that androgen-secreting ovarian tumours have to be considered in the differential diagnosis of severe hyperandrogenism even in peri-menopausal women.