Pure Leydig Cell Tumour (Hilus Cell) of the Ovary: A Rare Cause of Virilization after Menopause

Abstract

A 58-year-old postmenopausal woman with high plasma testosterone levels and virilization, as demonstrated by hirsutism and alopecia, is presented. Urinary 17-ketosteroids and 17-hydroxycorticosteroids as well as the computed axial tomography scan of the adrenal glands were normal. Although no pelvic mass was detected by sonography or pelvic examination, the patient was found to have small pure Leydig cell tumour of the left ovary. Following total abdominal hysterectomy and bilateral salpingo-oophorectomy, the patient had regression of the hirsutism, and the plasma testosterone dropped to normal level.

Use of a long-acting gonadotrophin-releasing hormone analogue in a postmenopausal woman with hyperandrogenism due to a hilus cell tumour

“…They arise from clusters of large steroidogenic cells, called hilus cells, normally found along the length of the ovaries of adult women (6)(7)(8). All aspects of their structure and function are identical to those of differentiated testicular Leydig cells.…”

“…Hilus cell tumours are typically small, unilateral, benign and usually found in postmenopausal women (7,10); 75% of them cause virilization (11). Approximately 33% to 50% of the cases are associated with endometrial hyperplasia that has been related to high serum levels of oestradiol (12), probably due to peripheral aromatization of testosterone.…”

Leydig Cell Tumour in a 46,XX Child with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

“…The hilar type tumours are typically very small with an average diameter of 3 to 5 cm, are often unilateral and mostly benign [5,6]. This kind of tumour may occur at any age but is most often diagnosed in women in the perimenopausal or postmenopausal period at a mean age of 58 years [3,4,5,6,7]. In children, such tumours may manifest with precocious puberty [8].…”

Androgenproduzierender Leydig-Zell-Tumor des Ovars als Ursache von Hirsutismus bei einer postmenopausalen Frau

“…Besteht aufgrund hoher Testosteronspiegel der Verdacht auf einen Ovarial- [6][7][8][9][10][11] oder Nebennierenrindentumor [12], muss eine weitergehende Diagnostik zur Lokalisation des Tumors erfolgen, die sich häufig als schwierig erweist [13]. Wie in unserer Fallbeschreibung kann es vorkommen, dass der gynäkologische Befund mit transvaginalem Ultraschall oder eine Computertomographie des Abdomens nicht richtungweisend ist [14].…”