Virilising ovarian tumors: a single-center experience

Abstract

Literature on virilising ovarian tumors (VOTs) is limited to case reports and series reporting single pathological type. We have analyzed the clinical, hormonal, radiological, histological, management and outcome data of VOT. This retrospective study was conducted at a tertiary health care center from Western India. Consecutive patients with VOT presenting to our endocrine center between 2002 and 2017 were included. Our study included 13 patients of VOT. Out of 13 patients, two were postmenopausal. All patients in the reproductive age group had secondary amenorrhea except one who presented with primary amenorrhea. Modified F and G score (mFG) at presentation was 24 ± 4.3 and all patients had severe hirsutism (mFG ≥15). Change in voice (n = 11) and clitoromegaly (n = 7) were the other most common virilising symptoms. Duration of symptoms varied from 4 to 48 months. Median serum total testosterone level at presentation was 5.6 ng/mL with severe hyperandrogenemia (serum testosterone ≥2 ng/mL) but unsuppressed gonadotropins in all patients. Transabdominal ultrasonography (TAS) detected VOT in all except one. Ten patients underwent unilateral salpingo-oophorectomy whereas three patients (peri- or postmenopausal) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Seven patients had Sertoli Leydig cell tumor, three had steroid cell tumor and two had Leydig cell tumor and one had miscellaneous sex cord stromal tumor. All patients had normalization of serum testosterone after tumor excision. In conclusion, VOTs present with severe hyperandrogenism and hyperandrogenemia. Sertoli Leydig cell tumor is the most common histological subtype. Surgery is the treatment of choice with good surgical outcome.

Clinical and ultrasound characteristics of virilizing ovarian tumors in pre- and postmenopausal patients: a single tertiary center experience

“…Our study is the first to demonstrate that VOTs are significantly smaller in postmenopausal women than in premenopausal women. In accordance with a previous report [ 6 ], the most common VOT was Sertoli-Leydig cell tumors. The present study revealed that the most common histotypes differed between premenopausal and postmenopausal patients, with Sertoli-Leydig cell tumors in premenopausal patients and Leydig cell tumors in postmenopausal patients.…”

The Leydig Steroid Cell Tumor in a Postmenopausal Woman with Clinical and Biochemical Hyperandrogenism: A Case Report

“…Study strength. Over the past decades, a relatively small number of clinical cases of LCTs and case series have been published [ 32 , 33 , 34 , 35 , 36 ]. Therefore, the demonstration of our observations is valuable and allows for replenishing the database available for pooled analysis.…”

Anovulación y amenorrea secundaria: enfoque fácil y práctico

“…Representan el 1-2% de la amenorrea con hirsutismo severo. Los tumores virilizantes ováricos pueden ser de Sertoli-Leydig, de la teca granulosa, de células lipídicas, de células hiliares, de restos adrenales, disgerminomas y gonadoblastomas (37,38). Por su parte, los suprarrenales son adenomas y carcinomas (39).…”