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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2021№1
Virilizing ovarian tumors in postmenopause:...

Virilizing ovarian tumors in postmenopause: a literature review and a rare clinical case

DOI
https://dx.doi.org/10.18565/aig.2021.1.178-185

Ponomareva Yu.N., Loginova E.A., Telezhnikova I.M.

A.S. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia
Background. Sertoli–Leydig cell ovarian tumors are rare and account for less than 0.5% of all ovarian tumors. Sertoli–Leydig cell tumors can develop in women of any age group; however, they are more common in young female patients with a mean age of 25 years. The distinguishing feature of Sertoli–Leydig cell tumors is their ability to secrete androgens that may cause defeminization. It is rather difficult to diagnose androgen-producing tumors in postmenopause, since the sharp decline in estrogen levels and a slower decrease in androgen levels while maintaining the synthesis throughout life are natural hormonal changes.
Case report. The paper analyzes literature data and a rare clinical case of Sertoli–Leydig cell tumor in postmenopausal female patient with breast cancer. The patient was observed to have pronounced signs of virilism: hirsutism, deepening voice, alopecia, and clitoromegaly. MRI revealed a 33-mm left solid ovarian tumor accumulating a contrast agent. She was diagnosed with an increase in blood testosterone levels up to 10 nmol/L (normal value, less than 1.24 nmol/L). The patient underwent surgical treatment: laparoscopy, hysterectomy, bilateral removal of the appendages, and omentectomy. Morphological examination diagnosed a moderate left Sertoli–Leydig cell ovarian tumor. The testosterone level was noted to decrease after surgery. No tumor recurred during one year of follow-up.
Conclusion. Thus, postmenopausal patients with pronounced signs of hyperandrogenism should be examined to exclude rare diseases, such as androgen-producing tumors.

Keywords

Sertoli–Leydig cell tumor
sex cord tumor
postmenopause
defeminization
virilization
androgen-producing tumors
hysterectomy
Full text (in Russian)

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Received 16.09.2020

Accepted 11.12.2020

About the Authors

Yulia N. Ponomareva, MD, PhD, Professor, Head of the Department of Gynecology, Moscow Clinical Scientific Center, Moscow Healthcare Department.
Tel.: +7(495)304-30-35. E-mail: y.ponomareva@mknc.ru. ORCID: 0000-0001-5436-9119.
11123, Russia, Moscow, shosse Entuziastov, 86.
Ekaterina A. Loginova, MD, Research Fellow of the Department of Gynecology, Moscow Clinical Scientific Center, Moscow Healthcare Department.
Tel.: +7 (495)304-30-35; +7(985)182-28-58. E-mail: e.loginova@mknc.ru. ORCID: 0000-0002-5061-1227.
11123, Russia, Moscow, shosse Entuziastov, 86.
Inessa M. Telezhnikova, Research Fellow of the Department of Morbid Anatomy, Moscow Clinical Scientific Center, Moscow Healthcare Department.
Tel.: +7 (495)304-30-35; +7(909)956-33-39. E-mail: inessssa@inbox.ru. ORCID: 0000-0002-1491-2882.
11123, Russia, Moscow, shosse Entuziastov, 86.

For citation: Ponomareva Yu.N., Loginova E.A., Telezhnikova I.M. Virilizing ovarian tumors in postmenopause: a literature review and a rare clinical case.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 1: 178-185 (in Russian)
https://dx.doi.org/10.18565/aig.2021.1.178-185

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