Salim Shihas, Shantha Ghanshyam Palamaner Subash, Patel Amish Dilip, Kumar Anita A, Ganeshram Prasanthi, Mehra Nikita, Rajan Anish George, Joseph Tarun, Sudhakar Lavangi
Department of General Medicine, Sri Ramachandra University, Chennai, India.
Cases J. 2009 May 18;2:7521. doi: 10.1186/1757-1626-2-7521.
Virilism is the masculinization and enhancement of male secondary sexual characteristics in females. The etiology is usually of adrenal or ovarian origin. Here we report a case of virilizing Leydig cell type, steroid cell tumor of the left ovary, in a 40 year old female who presented with clinical signs and symptoms of virilization: deepening of voice, hirsutism (Ferriman-Gallwey score 26), clitoromegaly, and androgenic alopecia. On further evaluation, laboratory investigations revealed hyperandrogenism in the male range. Basal testosterone values were elevated. Folicle Stimulating Hormone and Luteinising Hormone levels were within normal limits. Dexamethasone suppression test did not alter cortisol or testosterone levels. An ovarian mass was confirmed radiologically. Following a total abdominal hysterectomy with bilateral salpingoophorectomy, histopathological studies confirmed a left sided steroid-cell ovarian tumor, Leydig cell type (stage T(1)N(0)M(0)), which proved to the etiology of virilization in this patient. Post-operatively her serum testosterone levels declined with near-complete reversal of symptoms over time.
男性化是指女性体内男性第二性征的男性化和增强。其病因通常源于肾上腺或卵巢。在此，我们报告一例40岁女性的具有男性化表现的左侧卵巢睾丸间质细胞瘤（类固醇细胞瘤），该患者出现了男性化的临床症状和体征：声音变粗、多毛（费里曼 - 盖尔维评分26分）、阴蒂肥大和雄激素性脱发。进一步评估发现，实验室检查显示雄激素水平处于男性范围的高雄激素血症。基础睾酮值升高。促卵泡生成素和促黄体生成素水平在正常范围内。地塞米松抑制试验未改变皮质醇或睾酮水平。经影像学检查确认存在卵巢肿物。在进行全腹子宫切除术加双侧输卵管卵巢切除术后，组织病理学研究证实为左侧类固醇细胞性卵巢肿瘤，睾丸间质细胞型（T(1)N(0)M(0)期），这被证明是该患者男性化的病因。术后她的血清睾酮水平下降，随着时间推移症状几乎完全缓解。
