Laparoscopic removal of virilizing hilar cell tumor in a postmenopausal patient

Silva, Paul D.; Sorensen, Michelle L.; Reynertson, Richard H.; Virata, Rodelino L.; Mahairas, Gregory H.

doi:10.1016/s1074-3804(05)80047-7

Cited by 19 publications

(7 citation statements)

References 9 publications

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“…They are more commonly found in younger women and are frequently associated with virilization [19]. Previously, laparoscopic management of Sertoli-Leydig cell tumor was reported with favorable prognosis [4,10,11]. In the present study, we encountered a case of recurrent Sertoli-Leydig cell tumor that was initially treated by laparotomic tumorectomy.…”

Section: Discussionmentioning

confidence: 76%

“…Applications of laparoscopic surgery to benign cystic adnexal masses are well established as minimally invasive treatment procedures [1,2]. However, reports describing the application of laparoscopic surgery to solid adnexal tumors are limited [4,[10][11][12]. In contrast to a cystic adnexal mass that can be managed by laparoscopy after draining the cystic contents by aspiration, even when the tumor is large [15], in cases of solid adnexal tumor, the tumor size is a major limiting factor for laparoscopic manipulation of the tumor without damage.…”

Section: Discussionmentioning

confidence: 99%

“…Cases of solid/predominantly solid adnexal tumor first diagnosed by ultrasonography include various natures of neoplastic conditions from benign to malignant [6,7], and laparotomy is the usual approach to such cases. However, if cases are appropriately selected by careful evaluation of tumor characteristics [8,9] before and during surgery, management of solid adnexal tumor by laparoscopic surgery becomes possible [10][11][12].…”

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confidence: 99%

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Laparoscopic management of selected solid adnexal tumors

et al. 2006

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Fourteen cases of laparoscopically treated solid/ predominantly solid nonepithelial adnexal tumors are presented. Unilateral salpingo-oophorectomy was performed in seven cases [three fibromas, one thecoma, one strumal carcinoid, one Sertoli-Leydig cell tumor (G2), and one dysgerminoma], including a 21-year-old patient with fibroma with adnexal torsion. A 26-year-old patient with fibroma was treated by tumorectomy. Laparoscopicassisted vaginal hysterectomy and bilateral salpingooophorectomy were done in five cases [three thecomas, one adult-type granulosa cell tumor, one Sertoli-Leydig cell tumor (G2)], including a 52-year-old patient with thecoma complicated by torsion. In a case of adenomatoid tumor of the fallopian tube, unilateral salpingectomy was done. Adjuvant platinum-based chemotherapy was added in a case of dysgerminoma, and there has been no sign of recurrence after 3 years.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Laparoscopic management of selected solid adnexal tumors

et al. 2006

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“…Laparoscopic bilateral salpingo-oophorectomy may be regarded as the procedure of choice in a postmenopausal women with symptomatic hyperandrogenism, virilization, or both, who has no obvious ovarian or adrenal mass. [910] This approach avoids unnecessary investigations and delays in definitive management. Since preoperative probability of malignancy is extremely remote, extensive imaging procedures for metastatic disease, and open laparotomy are unnecessary.…”

Section: Resultsmentioning

confidence: 99%

Postmenopausal hyperandrogenism of ovarian origin: A clinicopathologic study of five cases

et al. 2016

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In postmenopausal women presenting with virilization and elevated testosterone levels, laparoscopic salpingo-oophorectomy should be considered after exclusion of adrenal causes. A clinicopathological study was conducted among those women who presented with features of hyperandrogenism in our postmenopausal clinic over a period of 2 years. Relevant past medical and surgical histories were elicited. Basic hormonal evaluation and radiological imaging were done. Laparoscopic bilateral salpingo-oophorectomy was done. Six weeks postoperatively, serum testosterone was undetectable with significant clinical improvement. There was no recurrence of symptoms during the follow-up period of 2 years. Treatment of postmenopausal women with hyperandrogenism and virilization with laparoscopic bilateral salpingo-oophorectomy is effective if she has no pronounced ovarian enlargement or adrenal tumor on imaging. An extensive endocrine testing and a detailed search for metastatic disease may be unnecessary.

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“…For example, long-acting GnRH analogues that suppress gonadotropin levels have been shown to normalize testosterone levels in some virilized women, suggesting that various ovarian androgen-secreting tumors, as well as hyperthecosis, are not entirely autonomous. 24 If an adrenal androgen source has definitively been excluded, bilateral oophorectomy in a postmenopausal woman is justified. Diagnostically, GnRH analogues may be of help in confirming an ovarian source of androgen production when there is uncertainty, as in a patient with both an adrenal adenoma and an ovarian lesion.…”

Section: Discussionmentioning

confidence: 99%

Leydig Cell Tumor of the Ovary in a Postmenopausal Woman Presenting With Virilization

Bancos

Prawius

2008

The Endocrinologist

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Mild hyperandrogenism associated with anovulation or hirsutism is present in 5% of women. Severe hyperandrogenism associated with virilization is much less common. It may be caused by either benign or malignant neoplasms of adrenal or ovarian origin. We report a case of a virilizing steroid cell ovarian tumor in a 78-year-old postmenopausal woman. Although the biochemical evaluation pointed to an ovarian source of androgen, diagnostic attempts to localize the source of hyperandrogenism with transvaginal ultrasound and computed tomography scan of pelvis and abdomen failed. Venous sampling was considered, but the patient opted for bilateral salpingo-oophorectomy. Section of the right ovary revealed a well-demarcated tumor measuring 1.9 cm in greatest dimension. The tumor was composed of solid aggregates of polygonal cells with granular eosinophilic cytoplasm. Cytoplasmic lipofuscin was identified. Intracytoplasmic Reinke crystals were found. Within hours of surgery, biochemical markers of hyperandrogenism had resolved. This article reviews the clinical and biochemical presentation of tumorous ovarian virilization, histologic classification of ovarian virilizing tumors, currently used localization studies, including ovarian venous sampling, and concludes with a summary of therapeutic options for Leydig cell ovarian tumors.

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Laparoscopic removal of virilizing hilar cell tumor in a postmenopausal patient

Cited by 19 publications

References 9 publications

Laparoscopic management of selected solid adnexal tumors

Laparoscopic management of selected solid adnexal tumors

Postmenopausal hyperandrogenism of ovarian origin: A clinicopathologic study of five cases

Leydig Cell Tumor of the Ovary in a Postmenopausal Woman Presenting With Virilization

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