TLDR Ovarian Leydig cell tumors are hard to diagnose with just advanced imaging; expert ultrasound and clinical evaluation are essential.
The document from 2018 presents a case series of three women with ovarian Leydig cell tumors, emphasizing the diagnostic challenges of these rare androgen-secreting tumors. Despite using modern imaging techniques like CT, MRI, and PET-CT, the tumors were not identified in two cases, and one had an inconclusive PET-CT. The document highlights the necessity of specialist gynecologic ultrasonography for diagnosis, as the tumors presented as small, solid, hyperechogenic nodules with increased vascularity on expert sonography. The combination of patient age, symptoms, high total testosterone levels, and skilled ultrasound were key diagnostic indicators. The document concludes that sophisticated imaging alone is insufficient for diagnosis and that a comprehensive evaluation, including clinical examination and expert ultrasonography, is crucial. It also calls for better training of sonographers in this specialty and suggests that a high index of suspicion is necessary for timely and appropriate treatment when initial imaging is inconclusive. The work was supported by Charles University in Prague and the Ministry of Health of the Czech Republic.
378 citations
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November 2011 in “Human reproduction update” Experts recommend using evidence-based methods to diagnose and treat hirsutism, focusing on symptoms and underlying causes.
502 citations
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February 2008 in “The Journal of Clinical Endocrinology & Metabolism” The guideline suggested testing for elevated androgen levels in women with abnormal hirsutism scores but not in eumenorrheic women with unwanted local hair growth. For women with significant hirsutism unresponsive to cosmetic measures, pharmacological therapy was recommended, with direct hair removal methods like electrolysis or photoepilation for additional cosmetic benefits. In cases of mild hirsutism without endocrine disorders, either pharmacological therapy or direct hair removal was suggested. Oral combined estrogen-progestin contraceptives were recommended as the primary pharmacological treatment, with the addition of an antiandrogen if needed after 6 months. Antiandrogen monotherapy was advised against unless adequate contraception was used, and insulin-lowering drugs were not recommended. Laser/photoepilation was suggested for most women opting for hair removal therapy.
271 citations
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December 2005 in “New England journal of medicine/The New England journal of medicine” The document likely offers guidance on treating a woman's excessive hair growth, considering her symptoms and obesity.
4 citations
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January 2019 in “Obstetrics & gynecology science” A PET-CT scan successfully located a hard-to-find Leydig cell tumor in a woman with hormonal symptoms.
A thorough diagnostic process and teamwork are crucial for managing complex hyperandrogenism in postmenopausal women.
14 citations
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December 2010 in “Seminars in Oncology” Rare adrenal cancers that secrete androgens or estrogens have a poor prognosis and are treated primarily with surgery.
27 citations
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April 2017 in “European journal of endocrinology” The research found that MRI and certain hormone levels can help tell apart ovarian tumors from hyperthecosis in postmenopausal women, but tissue analysis is still needed for a definite diagnosis.
5 citations
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October 2013 in “Endocrine” Blood tests can detect ovarian Leydig cell tumors when scans don't, and surgery can confirm and treat these tumors.
