Discriminating Between Virilizing Ovary Tumors and Ovary Hyperthecosis in Postmenopausal Women: Clinical Data, Hormonal Profiles, and Imaging Studies

April 2017 in “ European journal of endocrinology ”

Viviane Dos Reis Vieira Yance, J. A. M. Marcondes, Marco Rocha, Cristiano Roberto Grimaldi Barcellos, Wagner Silva Dantas, A. Ávila, Ronaldo Hueb Baroni, Filomena Marino Carvalho, Sylvia Asaka Yamashita Hayashida, Berenice Bilharinho Mendonca, Sorahia Domenice

virilizing ovarian tumors ovarian stromal hyperthecosis testosterone estradiol gonadotropin pelvic MRI ultrasound histopathological analysis LH levels VOT OH MRI LH

Studysummary This retrospective study found that serum hormone levels and MRI detection of ovarian nodules contributed to distinguishing virilizing ovarian tumors from ovarian stromal hyperthecosis in postmenopausal women, though histopathology remains crucial for diagnosis.

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The study analyzed 34 postmenopausal women, 13 with virilizing ovarian tumors (VOT) and 21 with ovarian stromal hyperthecosis (OH), to distinguish between these conditions which present with similar clinical and hormonal profiles. Clinical signs of virilization were more common in the VOT group. Hormonal analysis revealed that women with VOT had significantly higher testosterone and estradiol levels, and lower gonadotropin levels, but there was significant overlap between the groups. Pelvic MRI proved to be more accurate than ultrasound, with an 82% accuracy rate for diagnosing VOT. The best hormonal criteria for differentiation were testosterone levels >312.5 ng/dL and LH levels <10.8 IU/L. Despite these findings, histopathological analysis remained the definitive method for diagnosis. The study emphasized the need to use a combination of clinical, hormonal, and imaging data for accurate diagnosis, but confirmed that histopathology is essential for a definitive diagnosis.

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