Androgen secreting steroid cell tumor of the ovary in a young lactating women with acute onset of severe hyperandrogenism: a case report and review of literature

Abstract

Introduction: Steroid cell tumors of the ovary account for less than 0.1% of all ovarian tumors [1] and these tumours may present at any age in association with interesting presentations related to the hormonal activity and virilizing properties of tumor. Hayes and Scully [2] reported 63 cases in patients ranging from 2 to 80 years of age. The subtype, not otherwise specified, is associated with androgenic changes in approximately one half of patients with this tumour [1]. In a series of 63 cases from Massachusetts General Hospital, 94% of the tumors were found to be unilateral and 28.6% were malignant [3]. As most of these tumors are diagnosed at an early stage and do not recur or metastasize, little is known about their response to therapies such as chemotherapy or radiation [3].

Leydig cell tumour and mature ovarian teratoma: rare androgen-secreting ovarian tumours in postmenopausal women

“…The hormonal tests suggested an ovarian source, since serum hormone assay showed high levels of testosterone with normal levels of DHEA-S 9. Circulating levels of androstenedione and 17 OHP can also be elevated in androgen-secreting neoplasms, because some tumours may predominantly secrete these testosterone precursors 9. Morning serum 17 OHP concentration was increased in all patients, except patient 4, who presented a mature teratoma.…”

“…The postmenopausal onset and progressive virilisation had raised suspicion for an androgen-secreting tumour. The hormonal tests suggested an ovarian source, since serum hormone assay showed high levels of testosterone with normal levels of DHEA-S 9. Circulating levels of androstenedione and 17 OHP can also be elevated in androgen-secreting neoplasms, because some tumours may predominantly secrete these testosterone precursors 9.…”

Leydig cell tumour of the ovary localised with Positron Emission Tomography/Computed Tomography

“…They are small tumours (mean diameter, 2.4 cm), unilateral in more than 95% of cases, with excellent prognosis because almost all of them are benign [2,5]. Surgical removal of the affected ovary is the mainstay treatment of these tumours, although medical therapy using Gonadotrophin Releasing Hormone (GnRH) analogues has been tried in some cases [6,7].…”

A Rare Case of Ovarian Sertoli-Leydig Cell Tumor in Postmenopausal Woman Presenting with Alopecia

“…They are composed of granulosa cells, theca cells, sertoli cells, leydig cells and fibroblasts singly or in variable combinations [5,6]. Leydig cell tumor is a rare form and accounts for less than 0.1% of all ovarian tumors [7] and are usually benign and unilateral [8,9].…”