Endocrine Abstracts

A 66-year-old female patient presented post-menopausal with vaginal bleeding. She was on Oestrogen cream. The US showed a right ovarian cyst. The C125 was normal, and the uterine biopsy showed no malignancy. The bleeding continued and she was reviewed 4 months later. The MRI shows evidence of uterine adenomyosis. The right ovarian cyst is likely to represent a right ovarian endometrioma (32 × 28 × 30 mm). She was referred to the endocrine clinic for as increased hair growth and deepening of the voice. She noticed voice changes approximately four to six weeks ago with increased hair growth in her face, on the front and back of her body and her legs. She needed to shave every day. She later stopped shaving on the body hair because it grows very rapidly, however shaving the facial hair daily. she noticed that her sex drive had increased significantly. The Examination showed mild clitoromegaly with hirsutism. The hormonal profile showed a high testosterone of - 25.2 nmol/l, FAI - 86.9, SHBG 29, LH 12.1 U/l, FSH 21.6 U/l, and Estradiol 157. Her case was discussed in the Gynaecology MDT and she underwent laparoscopic bilateral salpingo-oophorectomy. The pathology report showed a Steroid cell tumour of the ovary - Stage1A. Following the surgery, the Testosterone was normal, and hyperandrogenism symptoms gradually resolved. Sex cord-stromal tumours (SCST) are a group of benign and malignant neoplasms. The pure sex cord tumours represent approximately 7-8% of all primary ovarian tumours. They secrete androgens, estrogens, or other steroid hormones that can cause clinical manifestations related to the hormonal profile. Ovarian SCSTs diagnosis is a histologic one. It is suspected preoperatively based on the presence of an adnexal mass combined with signs of estrogen or androgen excess or elevated levels of serum tumour markers. However, the diagnosis is confirmed by a histological specimen. Granulosa Cell tumours are the most common type of potentially malignant ovarian SCST; they comprise 2-5% of all ovarian malignant neoplasms and 90% of malignant SCSTs. Sertroli cell tumours and sex cord tumours with annular tubules are rare. Sertroli cell tumours are typically benign, but malignant behaviour is more likely in higher-grade diseases. Androgenic effects are common; estrogenic effects are less common. Surgery is the main therapeutic modality for the management of these tumours, while chemotherapy and hormonal therapy may be used in some patients with progressive and recurrent tumours