Cases reported "Hirsutism"

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1/10. Use of a long-acting gonadotrophin-releasing hormone analogue in a postmenopausal woman with hyperandrogenism due to a hilus cell tumour.

    OBJECTIVE: The aim of this study was to prove the utility of GnRH analogues for the suppression of androgen secretion in a postmenopausal woman with a suspected virilizing ovarian tumour. DESIGN AND methods: We present a case of a 72-year-old woman with virilization of recent onset. Hormonal studies revealed a fourfold increase in serum testosterone levels, normal dehydroepiandrosterone sulphate concentrations and high levels of serum 17-hydroxyprogesterone levels. Computed axial tomography scan of the ovaries was normal and the adrenal glands showed a discrete enlargement. The long-acting GnRH analogue, triptorelin, was injected initially (3.75mg i.m.) and serum hormone levels were measured weekly throughout one month. RESULTS: GnRH produced a decrease in serum testosterone levels to normal values, in parallel with the suppression of serum LH and FSH concentrations. The patient was treated for three months with triptorelin and she experienced an amelioration of the hyperandrogenic symptoms. In order to achieve a diagnosis, the patient was submitted to a laparotomy that revealed a small hilus cell tumour in the left ovary. CONCLUSION: GnRH analogues may offer a good therapeutic option in some states of gonadotrophin-dependent hyperandrogenism of ovarian origin.
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ranking = 1
keywords = cell tumour
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2/10. Androgenic adult granulosa cell tumor in a teenager: a case report and review of the literature.

    The clinicopathologic findings of the third case of androgenic adult granulosa cell tumor in patients younger than 15 years was presented and discussed in the light of the literature. A patient complaining of secondary amenorrhea and hirsutism with elevated levels of plasma total testosterone, dehydroepiandrosterone sulfate, free androgen index and serum inhibin A, and a left ovarian septated, cystic mass was admitted to the hospital. The inhibin A level was within normal levels in the first month postoperatively. Inhibin A could be a tumor marker of utmost importance particularly in patients with androgenic or hyperestrogenic symptoms, especially in cases where benign criteria are abundant such as young age, nonincreased levels of classic tumor markers, and ultrasonographic appearance without any suspicion of malignancy.
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ranking = 7.8531628565497
keywords = granulosa cell, granulosa
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3/10. hirsutism: a rare presentation of an adult granulosa cell tumor of ovary.

    Ovarian tumor with clinical manifestations like hirsutism, atrophic uterus, flattened breasts and absence of post-menopausal bleeding and atrophic endometrium was reported as an adult granulosa cell tumor (GCT) on histopathological examination, is discussed.
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ranking = 7.8531628565497
keywords = granulosa cell, granulosa
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4/10. Hilus cell pathology and hirsutism.

    Hilus cell abnormalities are uncommon causes of hirsutism with virilization. Although hilus cell tumours have been well described, hilus cell hyperplasia is rare and is poorly defined clinically. We describe three cases of hilus cell hyperplasia and compare them with a case of hilus cell tumour. Both pathologies were associated with increased testosterone and oestradiol secretion. Suppression of testosterone to the 'normal range' in response to exogenous oestrogen was seen only in the cases with hyperplasia; only partial responsiveness was seen in the case with hilus cell tumour. Bilateral oophorectomy offers the potential for cure for both hilus cell hyperplasia and tumour.
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ranking = 0.6
keywords = cell tumour
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5/10. Characteristics of in vitro steroidogenesis in a woman with hyperandrogenism, a granulosa cell tumor and polycystic ovary disease. A case report.

    A 20-year-old woman presented with hyperandrogenism presumed to be due to an androgen-secreting granulosa cell tumor. In order to confirm this unusual presentation, short-term tissue culture steroidogenesis of the granulosa cell tumor and contralateral polycystic ovary was performed. testosterone and androstenedione were produced only by the polycystic ovary, whereas the tumor was producing estradiol and progesterone. The studies of in vitro steroidogenesis prevented an incorrect interpretation of the clinical presentation.
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ranking = 9.4237954278597
keywords = granulosa cell, granulosa
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6/10. Lipid cell thecomas of the ovary.

    An ovarian tumour of mixed thecomatous and lipid cell structure is described and the clinical and pathological features of this and eleven previously reported cases are reviewed. Functionally the tumours resemble lipid cell tumours in being mainly androgenic and are similar in size range and age incidence to the 'adrenal' type. Three tumours however contained hilus (Leydig) cells with Reinke crystalloids. The tumours furnish additional evidence of the stromal origin of lipid cell tumours and the term 'lipid cell thecoma' is proposed for them as indicating their main morphological affinities. It is suggested that fibromas, fibrothecomas, thecomas, lipid cell thecomas and lipid cell tumours form a series of related stromatogenous tumours of relatively simple structure with functional correlations as one moves from left to right.
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ranking = 0.6
keywords = cell tumour
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7/10. The intraovarian sites of androgen and estrogen formation in women with normal and hyperandrogenic ovaries as judged by in vitro experiments.

    The status of oocytes, the follicular fluid concentrations of steroids, and the in vitro steroidogenic capacities of stromal tissue, thecal tissue, and granulosa cells from a 15-yr-old girl with primary amenorrhea, ovarian hyperandrogenism, insulin-resistant diabetes mellitus, and acanthosis nigricans were compared to those from normal adult human ovaries. Most oocytes (95%) in the antral follicles recovered from the hyperandrogenic ovaries were degenerative, and the antral fluid levels of testosterone were 30- to 200-fold higher than those in normal ovaries. granulosa cells from the hyperandrogenic ovaries produced mainly estradiol as did those from normal healthy follicles. The thecal tissues produced 2- to 6-fold more androgen than similar tissues from normal ovaries. However, the stroma from the hyperandrogenic ovaries produced 49- to 250-fold more testosterone than that generated by normal tissues. These data suggest that the removal of stromal tissue as well as follicular tissue from patients with certain types of hyperandrogenism may sometimes contribute to a reduction in androgen secretion.
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ranking = 1.5706325713099
keywords = granulosa cell, granulosa
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8/10. Congenital bilateral juvenile granulosa cell tumor of the ovary in leprechaunism: a case report.

    We report on a case of leprechaunism. In addition to the typical clinical and biochemical features, a bilateral juvenile granulosa cell tumor of the ovaries and cytomegalovirus hepatitis were found. The granulosa cell tumor may result from the mitogenic effect of insulin at high concentration, which acts via a mechanism mediated by insulin-like growth factor i receptors.
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ranking = 9.4237954278597
keywords = granulosa cell, granulosa
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9/10. A paradoxical inhibition of androgenic hyperproduction by a Sertoli-Leydig cell tumour ovary.

    A 17 year old woman was evaluated for amenorrhoea and severe hirsutism (Ferriman-Gallway index = 31). Pelvic ultrasound demonstrated a right unilateral ovarian mass (6 x 5 cm), whereas the computed tomography for the adrenal gland was normal. Endocrinological findings revealed normal concentrations of oestradiol, progesterone, dihydroepiandrosterone sulphate, cortisol, prolactin, follicle-stimulating hormone, luteinizing hormone and adrenocorticotrophic hormone (ACTH). Total testosterone, free testosterone, androstenedione and 17-hydroxy-progesterone concentrations, already elevated at basal conditions, did not increase after an ACTH test, whereas they decreased significantly after dexamethasone administration and increased after a human chorionic gonadotrophin test. Of all the tumour markers investigated, tissue polypeptide antigen and alpha 1-fetoprotein showed an increase in concentration. Selective venous ovarian catheterization indicated the presence of an androgen-producing tumour in the right ovary. The histopathological diagnosis was consistent with a Sertoli-Leydig cell tumour ranking between an intermediate and a poor grade of differentiation, with heterologous elements characterized by mucinous epithelium of the gastro-intestinal type. An endocrine evaluation performed postoperatively showed a normalization of all serum pathological hormones and tumour markers studied. Some particular aspects were focused on and discussed.
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ranking = 1
keywords = cell tumour
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10/10. Masculinizing granulosa cell tumour.

    A 23-year-old woman had oligomenorrhea, underdevelopment of the breasts, moderate hirsutism and increased serum testosterone values associated with a benign noncystic granulosa cell tumour of the left ovary. She was frail, irritable and apathetic. Since the age of 7 she had had periodic abdominal pain with nausea, vomiting and dizziness; irritability and occipital headache appeared when she was older. Her symptoms resolved and the masculinization did not progress after the tumour was removed. Only six similar well documented cases have been reported.
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ranking = 24.670300616802
keywords = granulosa cell tumour, granulosa cell, granulosa, cell tumour
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