Endocrine Abstracts

We present a rare case of a 50 years old lady who presented with new onset hirsutism and hoarseness of voice since 2 years. Investigations showed high serum testosterone, androstendione and free androgen index. All other systemic and endocrinology evaluation for hirsutism did not reveal any abnormality. CT scan of her abdomen showed a right ovarian mass which was confirmed as a Sertoli-Leydig cell tumour (stage Ia) on surgical staging and completely cured after bilateral salpingo-oophorectomy. Sertoli-Leydig cell tumours are a rare type of sex cord-stromal neoplasms constituting less than 0.5% of ovarian neoplasms. Over two-third of the patients are under the age of 40 years with mean age at diagnosis being 25 years. These tumours include pure Sertoli or pure Leydig cell tumours, however majority of them are mixed Sertoli-Leydig cell tumours also known as androblastomas. These tumours are generally considered as low-grade malignant tumours; however, they can be benign. About one third of these tumours may have hormonally active testicular structures in them, which produce androgens resulting in secondary amenorrhoea, irregular menstrual bleeding and virilisation. Due to extremely low incidence, evidence about the clinicopathological behaviour, prognostic factors and optimal management of these neoplasms is limited. Approach for the evaluation and diagnosis of causes of hirsutism and virilisation in middle aged females and relevant review of literature about Sertoli-Leydig cell tumours will be presented.