Hyperandrogenism Due to a Testosterone-Secreting Sertoli-Leydig Cell Tumor Associated With a Dehydroepiandrosterone Sulfate-Secreting Adrenal Adenoma in a Postmenopausal Woman: Case Presentation and Review of Literature |
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| Institution: | 1. Section of Endocrinology and Diabetes, Hospital Dr. Guillermo Rawson, School of Medicine, Catholic University of Cuyo, San Juan, Argentina.;2. Department of Medicine, Southwestern School of Medicine, Dallas, Texas, University of Southern California, Los Angeles, California.;3. Department of Medicine and Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California.;1. Hanjani Institute for Gynecologic Oncology, Abington Memorial Hospital, 1200 Old York Road, Abington, PA 19001, United States;2. NRG Oncology Statistical Office, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263, United States;3. East Carolina University, Greensville, NC 27858, United States;4. Cleveland Clinic Foundation, Cleveland, OH 44195, United States;5. Kagoshima City Hospital, Department of OB/GYN, Kagoshima City 892 8580, Japan;6. Hershey Medical Center, GYN/Oncology, Hershey, PA 17033, United States;7. Rush-Presbyterian St. Lukes Medical Center, Chicago, IL 60612, United States;8. University of Mississippi Medical Center, Jackson, MS 39216, United States;9. University of North Carolina School of Medicine, 101 Manning Drive, Chapel Hill, NC 27514, United States;1. Princess Margaret Cancer Centre, Toronto Canada;2. London Health Sciences Center, London, Ontario, Canada;3. Juravinski Cancer Center, Hamilton, Ontario, Canada;4. Chicago Phase II Consortium, University of Chicago Medical Center, USA;5. California Phase II Consortium, City of Hope Comprehensive Cancer Center, Duarte, USA;6. CTEP, National Cancer Institute, Bethesda, MD, USA;1. Gynecologic Oncology Division, University of Iowa, Gyn/Onc Division, Iowa City, IA 52242, United States;2. NRG Oncology Statistics & Data Management Center, Roswell Park Cancer Institute, Buffalo, NY 14263, United States;3. Division of Gynecologic Oncology, Maine Medical Center, Scarborough, ME 04101, United States;4. University of Kansas School of Medicine, Wichita CCOP, Wichita, KS 67208, United States;5. Division of Gynecologic Oncology, Rush-Presbyterian St. Lukes Medical Center, Chicago, IL 60612, United States;6. Dept. of OB/GYN, University of Washington, Seattle, WA 98195, United States;7. Dept. of OB/GYN, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States;8. Dept. of Gyn/Onc, Indiana University Medical Center, Indianapolis, IN 46202, United States;9. Ellis Fischel Cancer Center, Columbia, MO 65203, United States;10. Dept. of Oncology, Women & Infants Hospital, Providence, RI 02905, United States;1. From the Division of Endocrinology and Metabolism, Albany Medical Center, Albany, New York.;2. Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, New York. |
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| Abstract: | ObjectiveTo report a case of hyperandrogenism attributable to the presence of an adrenal adenoma secreting dehydroepiandrosterone sulfate (DHEA-S) and an ovarian Sertoli-Leydig cell tumor secreting testosterone in a postmenopausal woman.MethodsThe laboratory, radiologic, and pathologic findings in our case are described. In addition, the pertinent literature is reviewed.ResultsA 56-year-old woman presented with a history of gradual increase in facial and body hair, scalp hair loss, male pattern baldness, and deepening of her voice, beginning a few years after spontaneous menopause at age 49 years. She had hypertension, obesity, and type 2 diabetes mellitus. Laboratory tests showed elevated levels of total testosterone (348 ng/dL) and DHEA-S (2,058 μg/dL), and a left adrenal tumor (3 by 4 cm) was detected on abdominal computed tomographic scan. Laparoscopic left adrenalectomy was performed, and the pathologic diagnosis was adrenal adenoma. The DHEA-S returned to normal levels, but the serum testosterone concentration remained elevated. Transvaginal ultrasonography disclosed an ovarian tumor. Bilateral oophorectomy was performed, and an ovarian Sertoli-Leydig cell tumor was diagnosed. The hormonal and clinical picture normalized after this surgical intervention.ConclusionAfter extensive review of the literature, we believe that this is the first reported case of a coincidental DHEA-S-secreting adrenal adenoma and a testosterone-secreting ovarian Leydig cell tumor causing signs of virilization. (Endocr Pract. 2009;15:149-152) |
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