ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

BackgroundIt has been proposed that a serum testosterone level more than 200 ng/dL should raise suspicion of an androgen-producing neoplasm. Few cases have challenged this notion.CaseA 33-year-old nulligravid woman experienced 3 years of secondary amenorrhea and hirsutism for 9 months. Examination showed mild hirsutism localized to face and areolae. Ultrasound examination showed a 54 mm × 60 mm right ovary, multicystic, and a 30 mm × 20 mm left ovary, which are comparable to polycystic ovaries. Laboratory investigations were compatible with a diagnosis of polycystic ovaries with hyperandrogenemia. Follicle stimulating hormone level was 0.5 mlU/mL; luteinizing hormone level was 17.6 mlU/mL; and testosterone level was 146 ng/dL. The patient was given depot-leuprolide (7.5 mg, intramuscular). After 1 month, clinical parameters were unchanged except for levels of testosterone (8 ng/dL), follicle stimulating hormone (3.2 mlU/mL), and luteinizing hormone (<0.5 mlU/mL). Another depot-leuprolide injection was given. The patient discontinued therapy and returned 6 weeks after her last depot-leuprolide injection. The level of testosterone was 69 ng/dL, with other parameters unchanged. Three months later, the testosterone level was 183 ng/dL, with other parameters unchanged. She resumed depot-leuprolide treatment coupled with oral contraceptives to relieve side-effects. After 2 months of this therapy, the testosterone level was 7 ng/dL, but the right ovary measured 65 mm × 42 mm with 24-mm and 22-mm cysts noted. By 5 months, the level of testosterone remained consistent at 9 ng/dL, but the right ovary measured 50 mm × 63 mm with a 30-mm cystic structure. Examination of the patient consistently showed suppression of testosterone production, but ultrasound examination of the ovaries revealed an enlarged right ovarian cyst. After 6 months of observation, the patient underwent a right oophorectomy. Pathologic assessment revealed a gonadal stromal tumor. Final staging was Ic. The level of testosterone 2 months postoperation was 22 ng/dL.ConclusionsThis case challenges the concept that androgenic malignancies are associated with testosterone levels above 200 ng/dL. This is also the first reported case that shows the ability to suppress testosterone production in these tumors with depot-leuprolide, showing that testosterone suppression does not rule out the presence of these tumors.

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID