Ovarian Stromal Hyperthecosis

Brown, Douglas L.; Henrichsen, Tara L.; Clayton, Amy C.; Hudson, S.B.; Coddington, Charles C.; Vella, Adrian

doi:10.7863/jum.2009.28.5.587

Cited by 29 publications

(7 citation statements)

References 18 publications

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“…However, unlike PCOS where theca cells are confined to the area around cystic follicles, nests of luteinised theca cells are scattered throughout the ovarian stroma in hyperthecosis, contributing to the high androgen levels usually seen 8 14. Ovarian hyperthecosis is seen primarily in postmenopausal women; its occurrence in women of reproductive age group is extremely rare 15. Treatment involves the use of GnRH agonists in young women of reproductive age group.…”

Section: Discussionmentioning

confidence: 99%

Severe hyperandrogenism due to ovarian hyperthecosis in a young woman

et al. 2019

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Hyperandrogenism is a relatively common clinical problem. However, severe hyperandrogenism causing virilisation is rare. A 27-year-old woman presented with generalised hirsutism, clitoromegaly, breast atrophy and secondary amenorrhoea. She had serum testosterone levels elevated to the adult male range. Administration of gonadotropin-releasing hormone (GnRH) analogue resulted in >50% suppression of serum testosterone which was suggestive of luteinising hormone-dependent ovarian hyperandrogenism. Imaging studies of abdomen and pelvis were normal, and ovarian venous sampling failed to show a gradient between the two sides. A presumptive diagnosis of ovarian hyperthecosis was, therefore, considered. Medical treatment with GnRH analogue and combined oral contraceptive pills was initiated to which an excellent clinical and biochemical response was noted. This case highlights a rare presentation of ovarian hyperthecosis in a young woman with severe hyperandrogenism mimicking a virilising neoplasm.

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Section: Discussionmentioning

confidence: 99%

Severe hyperandrogenism due to ovarian hyperthecosis in a young woman

et al. 2019

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“…Furthermore, VT may not secrete substantial amounts of androgens [ 2 , 9 , 10 ]. Small VT may evade detection on scans [ 11-13 ]. Scans are also not helpful in distinguishing adrenal VT from incidentalomas [ 14-16 ] and ovarian VT can coexist with ovarian hyperthecosis (OH) [ 13 ].…”

mentioning

confidence: 99%

“…Scans are also not helpful in distinguishing adrenal VT from incidentalomas [ 14-16 ] and ovarian VT can coexist with ovarian hyperthecosis (OH) [ 13 ]. Positron emission tomography/computed tomography (PET/CT) is not well-studied in PH [ 1 , 11 ]. The gonadotropin-releasing hormone (GnRH) analogue stimulation test (GAST) has been used to evaluate women with hyperandrogenism.…”

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confidence: 99%

Gonadotropin-Releasing Hormone Analogue Stimulation Test Versus Venous Sampling in Postmenopausal Hyperandrogenism

Tng

Tan

2020

Journal of the Endocrine Society

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Postmenopausal hyperandrogenism can be due to excessive androgen secretion from adrenal or ovarian virilising tumours or non-neoplastic conditions. The aetiology of postmenopausal hyperandrogenism can be difficult to discern because of limited accuracy of current diagnostic tests. This systematic review compares the diagnostic accuracy of the GnRH analogue stimulation test against selective ovarian and adrenal vein sampling of androgens in distinguishing neoplastic from non-neoplastic causes of postmenopausal hyperandrogenism. Diagnostic test accuracy studies on these index tests in postmenopausal women were selected based on pre-established criteria. The true positive, false positive, false negative, and true negative values were extracted and meta-analysis was conducted using the hierarchical summary receiver operator characteristics curve method. The summary sensitivity of the GnRH analogue stimulation test is 10% (95% CI 1.1 – 46.7%) and that for selective venous sampling is 100% (95% CI 0 – 100%). Both tests have 100% specificity. There is limited evidence for the use of either test in identifying virilising tumours in postmenopausal hyperandrogenism.

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“…A male type of hair distribution is usually seen. 4,6,9 Obesity in women with PCOS is usually truncal, and they tend to have a high waist/hip ratio. It is associated with more severe forms of the disease including extreme anovulation, oligomenorrhea, and increased hirsutism, but non-obese women with PCOS may also present with these features.…”

mentioning

confidence: 99%

“…It is associated with more severe forms of the disease including extreme anovulation, oligomenorrhea, and increased hirsutism, but non-obese women with PCOS may also present with these features. 4,6,9 There is also insulin resistance in PCOS. Several mechanisms have been proposed for the state of insulin resistance.…”

mentioning

confidence: 99%

Clinical study of polycystic ovarian syndrome (PCOS) in tertiary care centre

Sowmya¹,

Anitha

2017

Int J Reprod Contracept Obstet Gynecol

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Background: A true definition of polycystic ovarian syndrome involves a blending of the morphological and histological ovarian changes with endocrine abnormalities associated with these changes. Objective of present study was to detect the differences among women with PCOS and without PCOS.Methods: Twenty-five subjects with PCOS were included in the study on first cum first basis and twenty-five non PCOS subjects just next to each PCOS cases were included as control group.Results: Mean age of PCOS and Non PCOS subjects were 42.68 and 43.88 years respectively. Sixteen percentage of PCOS were from higher socio-economic status, which was statistically significant. PCOS subjects had 96% hirsuitism, 48% acne, 4% heavy voice and breast atropy which was also statistically significant.Conclusions: Women with PCOS have a hormonal imbalance and metabolism problems that may affect their health and fertility, we found PCOS subjects are more in urban population with strong family history. Lifestyle modification and dietary modification helps for the long-term health prognosis. women who are at risk of PCOS to be educated and managed for the continuing health risk and planned potential therapeutic strategies. Further research has to look into possibility of genes linked into PCOS.

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Ovarian Stromal Hyperthecosis

Cited by 29 publications

References 18 publications

Severe hyperandrogenism due to ovarian hyperthecosis in a young woman

Severe hyperandrogenism due to ovarian hyperthecosis in a young woman

Gonadotropin-Releasing Hormone Analogue Stimulation Test Versus Venous Sampling in Postmenopausal Hyperandrogenism

Clinical study of polycystic ovarian syndrome (PCOS) in tertiary care centre

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