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Ovarian Leydig cell tumor and postmenopausal hirsutism with signs of virilisation
  1. Cátia Ferrinho,
  2. Eugénia Silva,
  3. Manuela Oliveira and
  4. João Sequeira Duarte
  1. Endocrinology, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Egas Moniz, Lisboa, Portugal
  1. Correspondence to Dr Cátia Ferrinho; catia.ferrinho{at}gmail.com

Abstract

A 71-year-old woman was referred to the endocrinology clinic to investigate postmenopausal hirsutism with 10 years of evolution. She had history of regular menses and menopause with 50 years old. Physical examination showed a male pattern facies, deepening of the voice, androgenic alopecia and hirsutism with a score of 23 according to the modified Ferriman-Gallwey scale. Testosterone and androstenedione were increased. Transvaginal ultrasound, abdominal and pelvic CT showed uterine fibroids with no pathological findings in the adrenals or ovaries. Since she had postmenopausal vaginal bleeding, uterine fibroids and suspicion of an ovarian source for her hyperandrogenism, total hysterectomy and bilateral oophorectomy were performed. Histopathological diagnosis was a Leydig cell tumour located in left ovary and endometrial carcinoma. Improvement of hirsutism was started to notice 1 month after the surgery and she was referred to the oncology clinic for adjuvant treatment.

  • endocrinology
  • menopause (including HRT)
  • gynecological cancer

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Footnotes

  • Contributors CF: was responsible for collecting data, bibliographic review, writing and revision of the final manuscript. ES: performed bibliographic review and revision of the final manuscript. MO and JSD: participated in the discussion of patient’s clinical approach and the main review of the final manuscript.

  • 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.