Mature teratoma, a rare cause of virilization in adolescence

Fidalgo, Mariana; Katz, Olivia; Fucci, A.; Navacchia, D.; Zerba, M.; Lonegro, Leopoldo; Giambini, D.

doi:10.1515/jpem.2011.096

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…The mean age at diagnosis of ovarian teratomas is 13 and is similar for patients with immature or mature teratomas. [5][6][7][8] All performances for virilization, androgens, and the androgen level returned to normal after surgery. 5 There are debates on whether mature teratomas have the function of androgen secretion, and currently only a few cases have been reported.…”

Section: Discussionmentioning

confidence: 99%

A Rare Adolescent Case of Female Pseudohermaphroditism With Adrenocortical Carcinoma and Synchronous Teratoma

He¹,

Peng²,

Qiu³

2013

Journal of Pediatric Hematology/Oncology

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A patient with female pseudohermaphroditism is chromosomally and gonadally a female individual but has male or ambiguous external genitalia. In this paper, we report a 12-year-old Chinese girl who was diagnosed with female pseudohermaphroditism characterized by clitoridauxe, hirsutism, acne, hypertension, and karyotype 46 XX. Computed tomography scan revealed a huge left abdominal mass with distant metastases to bilateral lungs and a concomitant pelvic teratoma. Because the left abdominal mass was unresectable, the patient underwent a biopsy of the abdominal mass and a radical resection of the pelvic teratoma. Histopathology confirmed that the left abdominal mass was an adrenocortical carcinoma (ACC) and the pelvic teratoma was a mature cystic teratoma originating from the left ovary. After surgery, the patient received a transcatheter arterial chemoembolization of ACC, combined with 2 g mitotane daily for systemic treatment. It was a pity that she died 8 months later after diagnosis. So far, as we know, the simultaneous occurrence of pseudohermaphroditism, ACC, and ovarian teratomas has not been reported in the literatures before.

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Section: Discussionmentioning

confidence: 99%

A Rare Adolescent Case of Female Pseudohermaphroditism With Adrenocortical Carcinoma and Synchronous Teratoma

He¹,

Peng²,

Qiu³

2013

Journal of Pediatric Hematology/Oncology

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An adolescent girl with coexisting ovarian mature cystic teratoma and HAIR-AN syndrome, an extreme subtype of polycystic ovarian syndrome

Wahab²,

Fung

et al. 2021

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary Polycystic ovarian syndrome (PCOS) is associated with menstrual irregularities, ovulatory dysfunction, hirsutism, insulin resistance, obesity and metabolic syndrome but is rarely associated with severe hyperandrogenaemia and virilisation resulting in male pattern baldness and clitoromegaly. Total serum testosterone greater than twice the upper limit of the reference range or free androgen index of over five-fold elevated suggests a diagnosis other than PCOS. We reported a case of a 15 years old obese girl presented with secondary amenorrhoea, virilising signs: frontal baldness, clitoromegaly and prominent signs of insulin resistance and marked acanthosis nigricans. Her total testosterone level was markedly elevated at 9.4 nmol/L (0.5–1.7 nmol/L) and MRI pelvis revealed a right ovarian mass with fat and cystic component and a left polycystic ovary. The patient underwent laparoscopic right ovarian cystectomy and histologically confirmed mature cystic teratoma. Post-operatively, her testosterone level declined but did not normalise, menses resumed but remained irregular. Her fasting insulin was elevated 85.2 mIU/L (3–25 mIU/L) and HOMA-IR was high at 13.1 (>2) with persistent acanthosis nigricans suggesting co-existing HAIR-AN syndrome, an extreme phenotype of polycystic ovarian syndrome. Learning points Rapid onset of hyperandrogenic symptoms, especially if associated with signs of virilisation must raise the suspicion of an androgen-secreting tumour. Total serum testosterone greater than twofold the upper limit of the reference range or free androgen indices over fivefold suggest a diagnosis other than polycystic ovarian syndrome (PCOS). High levels of testosterone with normal levels of the DHEA-S suggest an ovarian source. Ovarian androgen-secreting tumour and HAIR-AN syndrome, an extreme spectrum of PCOS can co-exist.

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Mature teratoma, a rare cause of virilization in adolescence

Abstract: Virilization in an adolescent patient can occur for multiple reasons (ovarian, suprarenal or exogenous reasons). We describe a 14-year-old patient with 1-year secondary amenorrhea, who had an ovarian mature teratoma as a cause of her clinical history.

Cited by 2 publications

References 5 publications

A Rare Adolescent Case of Female Pseudohermaphroditism With Adrenocortical Carcinoma and Synchronous Teratoma

A Rare Adolescent Case of Female Pseudohermaphroditism With Adrenocortical Carcinoma and Synchronous Teratoma

An adolescent girl with coexisting ovarian mature cystic teratoma and HAIR-AN syndrome, an extreme subtype of polycystic ovarian syndrome

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