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Case report
Bilateral microscopic Leydig cell ovarian tumors in the postmenopausal woman
  1. Taylor L Langevin1,
  2. Karen Maynard2,3 and
  3. Anil Dewan4
  1. 1University of New England College of Osteopathic Medicine, Biddeford, Maine, USA
  2. 2Department of Obstetrics and Gynecology, Southern New Hampshire Medical Center, Nashua, New Hampshire, USA
  3. 3Department of Obstetrics and Gynecology, University of New England College of Osteopathic Medicine, Biddeford, Maine, USA
  4. 4Pathology Specialists of New England, Southern New Hampshire Medical Center, Nashua, New Hampshire, USA
  1. Correspondence to Mrs Taylor L Langevin; tlittlefield1{at}une.edu

Abstract

A 64-year-old postmenopausal female patient presented with approximately 5 years of intermittent spotting, progressive hirsutism and significantly increased libido and clitoral hypersensitivity with spontaneous orgasms multiple times a day beginning a few months prior. Initial hormone work-up revealed elevated total serum testosterone, androstenedione and 17-hydroxyprogesterone. Luteinising hormone, follicle stimulating hormone, estradiol, dehydroepiandrosterone-sulfate, thyroid stimulating hormone and prolactin were all within normal limits. Initial suspicions suggested an androgen-secreting tumour, likely in the ovary. The lesion was undetectable on transvaginal ultrasound and abdominal–pelvic CT scan. Laparoscopic bilateral salpingo-oophorectomy was performed to remove the likely source of excess androgens. Visible gross lesions were not observed intraoperatively; however, bilateral Leydig (hilus cell) tumours were confirmed by histopathology. Serum testosterone, androstenedione and 17-hydroxyprogesterone levels were normalised postoperatively within 2 weeks and 1 month, respectively.

  • gynaecological cancer
  • reproductive medicine
  • menopause (including HRT)

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Footnotes

  • Contributors TL was the primary author of the case report and assisted with the patient's surgery. KM was the attending physician of the patient. KM was involved in all patient visits including pre-surgery work-up, surgery, and post-op follow-ups. KM obtained written consent from the patient, provided Figures 1-2, and collaborated in the write-up of the report. AD was the pathologist who analyzed the patient's frozen and routine specimens. AD provided Figures 3-5 and collaborated with portions of the report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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