Hyperthecosis: an underestimated nontumorous cause of hyperandrogenism

Męczekalski, Błażej; Szeliga, Anna; Maciejewska-Jeske, Marzena; Podfigurna, Agnieszka; Cornetti, Paulina; Bala, Gregory; Adashi, Eli Y.

doi:10.1080/09513590.2021.1903419

Cited by 29 publications

(42 citation statements)

References 43 publications

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“…The presence of aggregates of luteinised theca cells in the stroma of both ovaries was consistent with bilateral hyperthecosis. This finding can be responsible per se for the hyperandrogenemia diagnosed in our patient 10. However, the left ovary neoplasia that was suspected before surgery was also identified; microscopically, the tumour presented features leading to the diagnosis of ovarian steroid cell tumour, NOS; diagnosis was also supported by the diffuse positivity for inhibin and calretinin 6 20 21.…”

Section: Discussionmentioning

confidence: 55%

“…The severe hyperandrogenemia supports the suspicion of ovarian hyperthecosis or ovarian androgen-secreting tumours, although total testosterone levels are usually even higher with the latter 10. Transvaginal ultrasound is the gold standard to evaluate the ovaries;9 however, if the ultrasound does not identify any tumour, this possibility cannot be excluded, as these tumours can be very small, therefore compromising the ultrasound sensibility 17.…”

Section: Discussionmentioning

confidence: 99%

“…Ovarian hyperthecosis is a disorder associated with severe hyperandrogenism and insulin resistance, defined by the presence of nests of luteinised theca cells in the ovarian stroma, arising from the differentiation of the ovarian interstitial cells into steroidogenically active luteinised stromal cells 10. Although more common in postmenopausal women, it can also be found during the premenopausal period.…”

Section: Introductionmentioning

confidence: 99%

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Ovarian steroid cell tumour inducing virilisation in a postmenopausal woman

Pinto

Martins²,

Oliveira³

et al. 2022

BMJ Case Rep

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Hyperandrogenism with virilisation de novo in postmenopausal women is exceedingly rare, with aetiology oscillating between ovarian tumours, adrenal tumours, ovarian hyperthecosis and, less frequently, Cushing’s syndrome. We report a case of a postmenopausal woman in her late 60s, referred from her primary healthcare physician to a gynaecology appointment due to hirsutism and vasomotor symptoms. At physical examination, clitoromegaly was also identified. Blood tests revealed severe hyperandrogenemia, with total testosterone above 200 ng/dL, but transvaginal ultrasound and abdominal CT were unremarkable. Three months later, abdominal CT was repeated, revealing a moderate heterogeneous enhancement with 18 mm on the left ovary, which was confirmed by transvaginal ultrasound. Total laparoscopic hysterectomy with bilateral adnexectomy was performed. Histopathological examination reported an ovarian steroid cell tumour not otherwise specified on the left ovary and bilateral ovarian hyperthecosis. Two months later, the patient had normal total testosterone and the hirsutism complaints were completely absent.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ovarian steroid cell tumour inducing virilisation in a postmenopausal woman

Pinto

Martins²,

Oliveira³

et al. 2022

BMJ Case Rep

View full text Add to dashboard Cite

show abstract

“…Eine genetische Dispositionund die Stimulation der Hormonproduktion durch Gonadotropine werden als Einflussfaktoren diskutiert. Eine Assoziation mit Adipositas, Hyperinsulinämie und Insulinresistenz ist bekannt [2].…”

Section: Hyperthecosis Ovariieine Seltene Ursache Der Hyperandrogenämieunclassified

“…Hyperthecosis ovarii ist nur mittels histologischer Sicherung möglich. Die bilaterale Ovarektomie stellt neben dem diagnostischen Goldstandard auch die naheliegende Therapieoption der Wahl bei der postmenopausalen Patientin dar, sodass bei entsprechender Befundkonstellation die Operationsindikation gestellt werden sollte [2,3]. Bei Inoperabilität der Patientin oder bei den seltenen prämenopausalen Patientinnen mit Wunsch nach Fertilitätserhalt kann eine Therapie mit GnRH-Agonisten in Betracht gezogen werden [6].…”

Section: Eine Definitive Diagnosestellung Derunclassified