1/33. Hilus cell tumour of the ovary in a virilized, premenopausal woman. Case report and review of hyperandrogenism of ovarian origin.A 35 year-old woman presented with virilization and was found to have elevated serum testosterone levels. Investigation revealed an 11 mm hilus cell tumour in the left ovary. After unilateral oophorectomy, serum testosterone levels rapidly returned to normal levels. The various ovarian tumours and conditions causing virilization are described and a clinical approach to the investigation of virilization is outlined.- - - - - - - - - - ranking = 1keywords = cell tumour (Clic here for more details about this article) |
2/33. Virilizing ovarian dermoid cyst with peripheral steroid cells. A case study with immunohistochemical study of steroidogenesis.A case of virilizing ovarian dermoid cyst with peripheral steroid cells and virilization is reported in a 62-year-old woman. The level of testosterone dropped to normal after oophorectomy. The cyst wall was bordered by a discontinuous band of steroid cells focally accompanied by smooth muscle cells. Immunohistochemically, the steroid cells were enzymatically active and displayed a profile similar to the internal theca cells of ovarian follicles. These steroid cells were most probably modified stromal cells associated with smooth muscle metaplasia of the ovarian stroma.- - - - - - - - - - ranking = 3.2563155910016keywords = theca cell, theca (Clic here for more details about this article) |
3/33. An ovarian Sertoli-Leydig cell tumour in a 40 year old Ethiopian woman: case report.Sertoli-Leydig cell tumors of the ovary are uncommon ovarian tumors. They belong to the ovarian stromal neoplasm. The most striking mode of presentation of these tumours is virilization due to androgen secretion. But approximately 50% of patients with Sertoli-Leydig cell tumors have no endocrine manifestations and usually complain of abdominal pain or swelling. Occasional tumors have been associated with various estrogen syndromes. A forty year old Ethiopian lady with well differentiated sertoli-leydig cell tumor of the left ovary presenting with features of virilization is described with clinicopathological correlation and literature review.- - - - - - - - - - ranking = 0.8keywords = cell tumour (Clic here for more details about this article) |
4/33. Loss of gender difference in serum leptin levels and its slow recovery after successful surgery for Leydig cell tumours in two virilized females.One of the factors that predicts serum leptin levels is gender. It has been shown that sex steroid hormones, in particular testosterone, play an important role in the regulation of serum leptin levels. We had the opportunity to examine the effects of acute and chronic changes in serum testosterone levels on serum leptin concentrations in two virilized females harbouring testosterone-secreting ovarian tumours, before and after curative surgery. Chronically elevated basal testosterone levels (46 nmol/l) were associated with suppressed serum leptin levels (1.46 microg/l and 2.56 microg/l) vs. 12 age- and BMI-matched healthy subjects 9.89 /- 0.64 microg/l. leptin levels were determined from pooled serum samples assayed by commercial radioimmunoassay. High testosterone levels abolished the well known sexual dimorphism of serum leptin levels. Two weeks after curative resection of these tumours serum leptin levels were unaltered and started to increase progressively after one month. One patient received parenteral conjugated oestrogens while the other resumed spontaneous menstrual cycles. Three months after curative surgery obvious changes in body composition were registered (DEXA). Six months later further rise in serum leptin concentrations occurred without further changes in body composition. In conclusion, leptin levels did not change in spite of rapid changes in the steroid milieu, but in the long term increase in body fat stores, new steroid milieu and maybe other factors are important determining factors of serum leptin levels.- - - - - - - - - - ranking = 0.8keywords = cell tumour (Clic here for more details about this article) |
5/33. Ovarian steroid cell tumor and a contralateral ovarian thecoma in a postmenopausal woman with severe hyperandrogenism.A 49-year-old woman presented with rapidly progressing hirsutism, receding hairline, male-pattern baldness and deepening of voice, which had developed over the past 2 years. Hormonal evaluation showed a markedly elevated serum testosterone level (418 ng/dl) and no evidence of increased production of cortisol, dehydroepiandrosterone, dehydroepiadrosterone-sulfate, androstenedione, or 17-hydroxyprogesterone. Transvaginal ultrasound examination suggested the presence of a small mass within the left ovary, but all other radiological studies, including adrenal and ovarian computed tomography, magnetic resonance imaging, radio-labelled cholesterol scintigraphy and positron emission tomography, were negative. Subsequently, bilateral selective venous sampling showed a marked testosterone gradient in the right ovarian vein. Bilateral salpingo-oophorectomy was performed (the patient had had a previous vaginal hysterectomy), and histopathological examination revealed a 10-mm steroid cell tumor within the right ovary and a 15-mm thecal cell tumor within the left ovary. The postoperative serum testosterone level returned to normal and the patient showed a slow regression of clinical symptoms. The simultaneous occurrence of a virilizing ovarian steroid cell tumor and an apparently non-functioning thecoma within the contralateral ovary emphasizes the potential pitfalls that may exist in the preoperative evaluation of patients with markedly increased testosterone production.- - - - - - - - - - ranking = 2.1682469514572keywords = theca, thecoma (Clic here for more details about this article) |
6/33. Steroid cell tumour not otherwise specified during pregnancy: a case report and diagnostic work-up for virilisation in a pregnant patient.Steroid cell tumours not otherwise specified are rare ovarian tumours, which can cause foetal and maternal virilisation. This is the first case report that describes a steroid cell tumour not otherwise specified during pregnancy. Differential diagnosis, a diagnostic work-up and treatment are discussed.- - - - - - - - - - ranking = 1.2keywords = cell tumour (Clic here for more details about this article) |
7/33. A case of virilizing brenner tumor in a postmenopausal woman with stromal androgenic activity.Although there are several reports of brenner tumor showing estrogen activities, it is an extremely rare cause of androgen excess leading to virilism, and the source or mechanism of its androgen production is also unknown at present. A 74-year-old woman presented with lower abdominal pain and increased facial hair growth of 6-month duration. Bilateral ovarian tumors were detected, and her serum testosterone (1.7 ng/mL) and estradiol (75 pg/mL) levels were elevated. Bilateral salpingo-oophorectomy was performed. The ovarian tumors were diagnosed as benign brenner tumor associated with fibrothecoma-like and luteinized stromal cells. Postoperatively, the serum testosterone and estradiol levels decreased. Immunohistochemically, fibrothecoma-like stromal cells were positive for cytochrome P-450 aromatase, which catalyzes the conversion from androgen to estrogen, and negative for c-Jun protein, which has recently reported to attenuate estrogen biosynthesis by directly down-regulating transcription of the aromatase gene. On the other hand, luteinized stromal cells were negative for cytochrome P-450 aromatase and positive for c-Jun protein. It is suggested that androgen is produced mainly in the luteinized stromal cells, because androgen is not converted to estrogen caused by suppression of aromatase biosynthesis by c-Jun.- - - - - - - - - - ranking = 0.6256406208494keywords = thecoma (Clic here for more details about this article) |
8/33. Ovarian thecoma with androgenic manifestations in a postmenopausal woman.A 50-year-old woman, who presented with progressive androgenization, central obesity and severe hypertension, was initially suspected to have an adrenal virilizing tumor. Her serum testosterone level was in the male range (9.3-11.6 ng/ml) and was not suppressed with dexamethasone. Although no pathological abdominal or pelvic mass was detected, total hysterectomy and bilateral salpingo-oophorectomy was performed. Histopathological examination revealed a theca-cell tumor of the right ovary. Postoperatively the testosterone level returned to normal and the patient had regression of virilism. Our case illustrates that a virilizing ovarian tumor can be small and elude imaging studies, but may be detected by means of well-considered clinical management.- - - - - - - - - - ranking = 1.8554266410326keywords = theca, thecoma (Clic here for more details about this article) |
9/33. A testosterone-producing tumour in the mesovarium.An androgen-secreting adnexal tumour is presented. The tumour was a steroid cell tumour of the mesovarium, without crystals of Reinke, hence the diagnosis was a steroid cell tumour (lipid cell tumour), not otherwise specified (in this case, because of its location in the mesovarium, an adrenal rest tumour). The clinical presentation, diagnosis, prognosis and differential diagnosis of virilizing adnexal tumours are discussed.- - - - - - - - - - ranking = 0.4keywords = cell tumour (Clic here for more details about this article) |
10/33. Thecal cell reaction associated with an ovarian leiomyoma and presenting with virilization.A 56-year-old woman presented with marked hirsutism and virilization of gradual onset. menstruation had ceased at 43 years. The serum testosterone was grossly elevated (49 nmol/l) with levels of estradiol well above the postmenopausal range (200 pmol/l). Both serum testosterone and estradiol levels showed a marked but transient increase during the administration of the GnRH analog, buserelin. This indicated that the release of these steroids was under gonadotropin control. Bilateral oophorectomy revealed a greatly enlarged left ovary, and histology demonstrated a leiomyoma of the ovary with marked thecal reaction, which was probably responsible for the elevated serum testosterone and virilization. testosterone levels returned to normal after bilateral oophorectomy. Excessive thecal androgen production associated with non-epithelial ovarian tumors is extremely uncommon and the response to buserelin has not previously been reported.- - - - - - - - - - ranking = 1.2082907986675keywords = theca (Clic here for more details about this article) |
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