An Ovarian Leydig Cell Tumor Undetected by Ultrasound in a Postmenopausal Woman with Hirsutism and Hyperandrogenism
March 2018
in “
Medicine
”
Leydig cell tumor hirsutism hyperandrogenism testosterone CT MRI adnexal mass laparoscopic total abdominal hysterectomy bilateral salpingo-oophorectomy androgen-secreting tumors histopathologically laparoscopic bilateral oophorectomy high testosterone CT scan MRI scan ovarian mass hysterectomy oophorectomy
TLDR A postmenopausal woman's hirsutism and high testosterone levels improved after surgery for an ovarian tumor not seen on ultrasound.
In 2018, a 60-year-old postmenopausal woman with severe hirsutism and hyperandrogenism was diagnosed with an ovarian Leydig cell tumor (LCT), which was not detected by ultrasound but was found using CT and MRI. Despite normal levels of other hormones, her serum testosterone was markedly elevated. After a vaginal ultrasound failed to locate the tumor, further imaging revealed a right adnexal mass. She underwent a laparoscopic total abdominal hysterectomy and bilateral salpingo-oophorectomy, leading to normalized testosterone levels and improvement of symptoms. The case underscores the need to consider androgen-secreting tumors in similar patients and suggests that CT and MRI are valuable when ultrasound results are negative. The LCT diagnosis was confirmed histopathologically, and laparoscopic bilateral oophorectomy was recommended as a cost-effective treatment over hormone therapy, offering definitive diagnosis and reducing the need for follow-up.
