Cases reported "Virilism"

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1/27. 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.
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ranking = 1
keywords = cell tumour
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2/27. Masculinizing granulosa cell tumor of the ovary in a postmenopausal woman. A case report.

    BACKGROUND: A total of 32 cases of virilizing granulosa cell tumors of the ovary have been reported. The current case has some unique features not previously reported. CASE: A 78-year-old woman presented with symptoms and signs of masculinization. A large, painless abdominal mass was discovered. Exploration revealed the mass to be originating in the left ovary, and surgical resection resulted in prompt reversal of the clinical and biochemical hyperandrogenic manifestations. Morphologic studies demonstrated a homogeneous granulosa cell tumor. CONCLUSION: This is the oldest patient on record with a masculinizing granulosa cell tumor and also the only masculinizing tumor presenting with advanced, stage III disease. Such tumors, although rare, should be considered in the differential diagnosis in postmenopausal women presenting with masculinizing symptoms.
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ranking = 5.1529549066164
keywords = granulosa cell, granulosa
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3/27. 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.
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ranking = 0.8
keywords = cell tumour
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4/27. 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.
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ranking = 0.8
keywords = cell tumour
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5/27. 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.
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ranking = 1.2
keywords = cell tumour
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6/27. The steroid profile of a virilizing ovarian tumor.

    A case report of a 25-year-old female with a sex cord stromal virilizing ovarian tumor is presented. The pathway of ovarian steroid secretion in this tumor is elucidated with the dominant elements being pregnenolone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, androstenedione, and testosterone. The tumor primarily made testosterone (T) with lesser elevations of androstenedione (A), dehydroepiandrosterone (DHEA), and dihydrotestosterone (DHT). Expert pathologic opinions differed whether this neoplasm was a Sertoli-Leydig tumor or a virilizing granulosa tumor; therefore, it was probably a gynandroblastoma. A unilateral salpingo-oophorectomy was performed and the patient promptly resumed normal ovarian function with ovulation.
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ranking = 0.27456488468833
keywords = granulosa
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7/27. 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.
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ranking = 0.4
keywords = cell tumour
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8/27. Virilizing granulosa cell tumor responsive to human chorionic gonadotropin and oral contraceptive with 8-year followup.

    Urinary and serum steroid measurements were obtained in a 48-year-old female before and after the removal of a virilizing granulosa cell tumor (GCT). Preoperatively, serum testosterone was markedly elevated while 17-ketosteroid (17-KS) and estrogen excretion were normal. chorionic gonadotropin administration effected a marked rise in urinary 17-KS excretion and serum testosterone while oral contraceptive therapy for 21 days decreased serum testosterone to normal. With tumor resection, serum testosterone fell to normal and subsequent administration of HCG had no stimulatory effect on serum testosterone or urinary 17-KS excretion. The patient's clinical response and 8-year followup attest to the tumor's unusual virilizing role.
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ranking = 3.6806820761545
keywords = granulosa cell, granulosa
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9/27. Theca lutein cysts with maternal virilization and elevated serum testosterone in pregnancy.

    A clinicopathological study was performed on a pregnant patient with bilateral multiple ovarian cysts, who presented with pre-eclampsia, marked virilization and exceedingly high levels of serum testosterone. The female fetus showed no evidence of virilization. Microscopic examination of the ovaries revealed theca lutein cysts with granulosa cells which showed the existence of testosterone by immunoperoxidase staining.
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ranking = 0.73613641523091
keywords = granulosa cell, granulosa
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10/27. Hormone studies in a case of virilisation due to ovarian tumour.

    The investigation is described of a 62-year-old female patient who presented with severe virilisation; her plasma testosterone concentration was grossly elevated at 37.9 nmol/L. Measurement of plasma androstenedione, dehydroepiandrosterone (DHEA) and DHEA-sulphate, urinary 17-oxosteroids and urinary 'free' cortisol suggested an ovarian source of androgens. An ultrasound scan indicated the presence of an ovarian mass which was removed and classified as a Sertoli-Leydig cell tumour (arrhenoblastoma) combined with a mucinous cystadenoma. Following operation plasma testosterone levels returned to normal. The excessive pre-operative testosterone production appeared to have had little effect on the plasma level of SHBG, since levels remained similar before and after removal of the tumour. serum LH and FSH levels were higher post-operatively.
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ranking = 0.2
keywords = cell tumour
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