Androgen-Secreting Ovarian Tumors

Macut, Djuro; Ilić, Dušan; Stevanovic, Aleksandar; Bjekić-Macut, Jelica

doi:10.1159/000494906

Cited by 30 publications

(30 citation statements)

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“…Granulosa cell ovarian tumors are known to secrete estrogen rather than androgens (8). However, rare reports of androgen-secreting granulosa cell tumor have appeared in the literature though without virializing manifestations (9)(10)(11)(12)(13).Therefore, the concern regarding the diagnosis of PCOS alone in this subject was legitimate in light of worsening manifestations despite appropriate therapy recommended by various organizations as well as other published guidelines (2,5). The concurrent presence of a testosterone-secreting granulosa cell tumor in addition to PCOS confirmed our suspicion regarding the diagnosis of PCOS alone being responsible for virializing manifestations.…”

Section: Discussionmentioning

confidence: 99%

More Than Meets the Eye in a Patient With Pcos: Androgen-Secreting Granulosa Cell Ovarian Tumor in a Virilized Woman With Polycystic Ovarian Syndrome (Pcos)

Harris¹,

Kabadi²

2020

AACE Clinical Case Reports

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Granulosa cell ovarian tumors are known to secrete estrogen. Herein we report a patient presenting with primary amenorrhea and virilization with markedly high androgen levels, all thought to be disproportional to be attributed to PCOS alone. Bilateral oophorectomy revealed a rare androgen secreting granulosa cell ovarian tumor and bilateral cysts (PCOS) both contributing to manifestations. Clinical Case: A 25 year old female presented with primary amenorrhea, male pattern baldness and hirsutism of the face and chest, clitoral hypertrophy, cystic acne on chest and shoulders and Type 2 Diabetes. Diagnosis of PCOS was made at age 13 years. Concurrent presence of congenital adrenal hyperplasia was also considered. She was receiving metformin, oral contraceptives and/or spironolactone with no improvement in manifestations at presentation to endocrine clinic. She reported several elevated serum testosterone and androstenedione levels. Diagnosis of PCOS was established by presence of enlarged cystic ovaries on ultrasound examination. Patient reported worsening manifestations including progression of Diabetes despite therapy with metformin. She shaved face, chest and breasts daily for cosmetic reasons. Laboratory testing demonstrated markedly elevated total testosterone (234 ng/dl), normal cortisol and ACTH levels. Dexamethasone suppression and HCG stimulation indicated ovaries as a probable source of excessive circulating androgen levels. CT scan of the abdomen and pelvis showed multiple cysts in both ovaries, largest being 1.9 cm in right ovary. Due to severity of manifestations, patient was counseled to undergo fluoroscopically guided blood sampling of bilateral adrenal and ovarian veins which confirmed both ovaries to be the source of the excess androgen production with a greater contribution by the right ovary. Patient underwent bilateral oophorectomy. Pathological examination confirmed the presence of bilateral polycystic ovaries as well as androgen secreting granulosa cell tumor in right ovary which apparently contributed to greater androgen levels in right ovarian venous blood sample. Peripheral venous androgen levels normalized promptly after bilateral oophorectomy. Gradual resolution of clinical manifestations followed. Conclusion: A unique presentation of granulosa cell ovarian tumor with concurrent polycystic ovarian syndrome contributing to the extremely excessive production of androgens in a young woman manifesting primary amenorrhea and masculinization at the onset of puberty with marked gradual resolution of manifestations following bilateral oophorectomy.

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Section: Discussionmentioning

confidence: 99%

More Than Meets the Eye in a Patient With Pcos: Androgen-Secreting Granulosa Cell Ovarian Tumor in a Virilized Woman With Polycystic Ovarian Syndrome (Pcos)

Harris¹,

Kabadi²

2020

AACE Clinical Case Reports

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“…[ 8 ] Ovarian tumors associated with androgen secretion mainly originate from the sex cord stroma and include Leydig tumor and stromal luteoma. [ 9 10 ]…”

Section: Discussionmentioning

confidence: 99%

Female androgenetic alopecia with male pattern caused by an androgen-producing tumor

Dueñas

Dueñas²,

Sánchez³

et al. 2020

Int J Trichol

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Female androgenetic alopecia (FAGA) is a common cause of hair loss in women. Typically, it is characterized by a reduction of hair density on biparietal and vertex regions of the scalp with preservation of the anterior hair implantation line. However, it can also appear with recession of the anterior hairline known as FAGA with male pattern (FAGA-M). In these cases, it is important to consider a state of hyperandrogenism and look for other signs such as hirsutism, acne, and menstrual irregularities. A sudden onset in a postmenopausal woman must make us suspicious of an androgen-secreting tumor. We present two cases of FAGA-M secondary to an ovarian tumor that was successfully resolved after surgical treatment.

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“…Андрогенопродукуючі пухлини яєчників здебільшого походять з клітин статевого тяжу, зустрічаються і пухлини суто стромального походження [56].…”

Section: пухлинні причини га в менопаузіunclassified

“…Як випливає з наведених вище даних, змішаний характер секреції при гормонопродукуючих пухлинах при ГА в менопаузі не завжди дозволяє визначити їх походження (яєчники/ наднирники). До того ж, описані випадки поєднання гормонально неактивних пухлин наднирників із недіагностованою раніше нВГКН або яєчниковим гіпертекозом [40,56].…”

Section: висновкиunclassified

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Androgen synthesis in menopause and diagnosis of causes of hyperandrogenism in menopause

Бурка¹,

Тутченко²

2019

Reproductive Endocrinology

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Androgen-Secreting Ovarian Tumors

Cited by 30 publications

References 0 publications

More Than Meets the Eye in a Patient With Pcos: Androgen-Secreting Granulosa Cell Ovarian Tumor in a Virilized Woman With Polycystic Ovarian Syndrome (Pcos)

More Than Meets the Eye in a Patient With Pcos: Androgen-Secreting Granulosa Cell Ovarian Tumor in a Virilized Woman With Polycystic Ovarian Syndrome (Pcos)

Female androgenetic alopecia with male pattern caused by an androgen-producing tumor

Androgen synthesis in menopause and diagnosis of causes of hyperandrogenism in menopause

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