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Hyperandrogenism due to ovarian Leydig cell tumour presenting with polycythaemia
  1. Ayşe Y Demir1,
  2. Bas B Blok2,
  3. Egbert A Brinkhuis3 and
  4. Christine P Oldenburg-Ligtenberg2
  1. 1Department of Clinical Chemistry and Haematology, Meander Medical Centre, Amersfoort, The Netherlands
  2. 2Department of Internal Medicine, Meander Medical Centre, Amersfoort, The Netherlands
  3. 3Department of Gynaecology and Obstetrics, Meander Medical Centre, Amersfoort, The Netherlands
  1. Correspondence to Dr Ayşe Y Demir; ay.demir{at}meandermc.nl

Abstract

A postmenopausal woman in her 60s was referred due to an elevated haemoglobin value found during her annual check-up. On physical examination, characteristic features of hyperandrogenism were observed which were not earlier mentioned. Laboratory investigations revealed polycythaemia accompanied by a normal erythropoietin and a negative analysis for JAK2-V617F mutation. A disproportionally and markedly elevated testosterone in combination with normal levels of adrenal androgens raised the suspicion of an ovarian source. CT scan showed nodular hyperdense lesions in both ovaries. A bilateral oophorectomy was performed and histological evaluation unfolded a Leydig cell ovarian tumour. Testosterone levels and haematological parameters normalised after surgery. Polycythaemia secondary to hyperandrogenism in postmenopausal women is an extremely rare condition and patients should be carefully analysed for the presence of androgen-secreting neoplasms. Diagnosis of the underlying pathology requires careful history, physical examination and comprehensive investigation. Treatment for this condition is surgery and resolves polycythaemia.

  • endocrinology
  • haematology (incl blood transfusion)
  • obstetrics and gynaecology

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Footnotes

  • Contributors AYD, BB, EB and CPO-L were involved in the diagnosis, treatment and follow-up of the patient and contributed to the preparation and writing of the 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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