Ovarian Hyperthecosis: A Rare Cause of Hyperandrogenemia

Abstract

A 30 year old Indian woman presented to the ObGy Department with history of amenorrhea for two years associated with progressively increasing hirsuitism, clitoral hypertrophy and generalised hyperpigmentation of skin all over her body. On evaluation her serum testosterone was found to be elevated (403ng/dl). Endocrine evaluation revealed glucose intolerance and a mild elevation in ACTH. CT Scan of the Abdomen and Pelvis revealed mildly enlarged ovaries bilaterally and normal adrenal gland anatomy. In view of an ovarian pathology she underwent wedge resection of both ovaries and histopathology of the ovaries was reported as ovarian hyperthecosis. Postoperatively she was given an antiandrogen flutamide and a short course of dexamethasone following which she resumed her menstrual function within 2 months and showed a improvement in androgenic symptoms after 6 months. Hence Wedge resection of ovaries followed by antiandrogens and corticosteroids postoperatively is an effective method of treating hyperandrogenic symptoms.