Department of Diabetes and Metabolic Medicine, National Center for Global Health and Medicine, Japan.
Am J Med Sci. 2011 Jan;341(1):74-7. doi: 10.1097/MAJ.0b013e3181f54e59.
A 74-year-old woman with impaired glucose tolerance exhibited virilization. An examination of various hormone levels showed normal pituitary hormone and adrenal hormone levels. However, the patient's blood testosterone level was remarkably high and was suspected of having caused the virilization. An abdominal computed tomography revealed a multilocular cystoma in the left ovary with the features of a mature cystic teratoma. In addition, a chest computed tomography revealed the presence of a mass in the left breast that was subsequently diagnosed as breast cancer based on the results of a biopsy. After the simultaneous surgical resection of the ovarian and breast tumors, her blood testosterone level decreased. The mature cystic teratoma containing a Brenner tumor was considered to be responsible for the high testosterone level because of the presence of androgenic enzymes. This case is extremely rare, but the case was accurately diagnosed through a comprehensive analysis.
一位 74 岁的女性患者糖耐量受损,出现男性化表现。各种激素水平检查显示垂体激素和肾上腺激素水平正常。然而,患者的血睾酮水平显著升高,疑似导致了男性化。腹部 CT 显示左侧卵巢多房性囊瘤,具有成熟囊性畸胎瘤的特征。此外,胸部 CT 显示左侧乳房有一肿块,随后根据活检结果诊断为乳腺癌。卵巢和乳腺肿瘤同时切除后,患者的血睾酮水平下降。含有 Brenner 肿瘤的成熟囊性畸胎瘤由于存在雄激素酶,被认为是导致高睾酮水平的原因。这种情况极其罕见,但通过综合分析准确诊断了该病例。