Leydig cell tumors in a postmenopausal women: case report

Kammoun Fatma; Sabrine Mekni; Sawsen Essayeh; Rihab Laamouri; Werfili Mariem; Mchirgui Nadia; Karima Khiari; Imen Rojbi; Nacef Ibtissem Ben

doi:10.1530/endoabs.99.EP1289

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Endocrine Abstracts (2024) 99 EP1289 | DOI: 10.1530/endoabs.99.EP1289

ECE2024 Eposter Presentations Late Breaking (127 abstracts)

Leydig cell tumors in a postmenopausal women: case report

Kammoun Fatma ^1,2 , Sabrine Mekni ^1,3 , Sawsen Essayeh ^3,4 , Rihab Laamouri ^3,4 , Werfili Mariem ³ , Mchirgui Nadia ⁴ , Karima Khiari ^3,4 , Imen Rojbi ^3,4 & Ibtissem Ben Nacef ^3,4

Err

Author affiliations

¹Charles Nicolle Hospital, Endocrinology, Tunisia; ²Charles Nicolle Hospital, Laboratory of Renal Pathology LR00SP01, Tunis; ³Charles Nicolle Hospital, Laboratory of Renal Pathology LR00SP01, Tunis, Tunisia; ⁴Charles Nicolle Hospital, Endocrinology, Tunis, Tunisia

Introduction: Virilizing ovarian tumors (VOT) are a rare cause of hyperandrogenism in postmenopausel women. Leydig cell tumors (LCTs) are rare sex-cord stromal tumors as they account for less than 0, 1 % of all ovarian tumors, and although they occur at any age, approximately one-fourth of them present after menopause. We report a clinical case of Leydig cell tumor in a postmenopausal woman.

Case-report: A 75-year-old woman, with a personnel history of type 2 diabetes mellitus, hypertension, and dyslipidemia presented with sudde nonset of virilization, hirsutism, androgenetic alopecia, and deep voice. On physical examination, she had positive signs of virilization, including temporal balding, coarse hair with a Ferriman-Galleway score of 36. The baseline laboratory values were as follows: DHEA-sulfate 35 µg/dl (normal range 15-220 µg/dl); androstenedione, 525 ng/dl (normal: 20-310 ng/dl); and total testosterone, 3.85 ng/ml (normal 0.03-0.4 ng/ml). On pelvic ultrasound, the patient’s right ovary was enlarged but the echostructure was normal and there were no other findings. Pelvic MRI revealed a low-intensity mass in the right ovary measuring 35 mm. The patient underwent exploratory laparotomy with bilateral salpingo-oophorectomy. Histopathologic examination of the resected ovaries revealed a Leydig cell tumor of the right ovary. Six weeks later, her serum testosterone and androstenedione levels, normalized to the normal range for women. Four months after surgery, the patient showed significant improvement in hirsutism and virilization symptoms.

Conclusion: Although LCT is rare and difficult to diagnose biochemically or with imaging studies, androgen-secreting tumors should be considered in postmenopausal women with hyperandrogenism and hirsutism.