卵巢源性高雄激素血症：利用差异静脉采血进行诊断。
Hyperandrogenism of ovarian etiology: utilizing differential venous sampling for diagnosis.
机构信息
From the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, and Departments of Medicine and Radiology, University of Virginia, Charlottesville, Virginia.
出版信息
Obstet Gynecol. 2012 Aug;120(2 Pt 2):476-479. doi: 10.1097/AOG.0b013e31825a711c.
BACKGROUND
We report the diagnosis and management of testosterone hypersecretion in the presence of an adrenal mass and no initially discernible ovarian mass.
CASE
A 64-year-old woman with severe hyperandrogenism, including serum testosterone 392 ng/dL, male-pattern baldness, and hirsutism, required bilateral ovarian and adrenal venous sampling to determine the source of the testosterone. Once an ovarian origin was confirmed, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed for definitive treatment. The adrenal adenoma was left in situ. There was a dramatic decrease in subjective symptomatology and normalization of testosterone postoperatively.
CONCLUSION
Preoperative differential venous sampling determined the correct source of testosterone. Subsequent removal of the ovary and steroid cell tumor correctly treated the hyperandrogenism and avoided an unnecessary surgical procedure for the adrenal adenoma.
背景
我们报告了在存在肾上腺肿块且最初无法识别卵巢肿块的情况下，睾丸激素分泌过多的诊断和处理。
病例
一位 64 岁女性患有严重的高雄激素血症，包括血清睾丸酮 392ng/dL、男性型秃发和多毛症，需要进行双侧卵巢和肾上腺静脉取样以确定睾丸酮的来源。一旦确定卵巢来源，为了进行确定性治疗，进行了全子宫切除术和双侧输卵管卵巢切除术。肾上腺腺瘤保留在原位。术后主观症状明显减轻，睾丸酮恢复正常。
结论
术前的静脉差异取样确定了睾丸酮的正确来源。随后切除卵巢和类固醇细胞瘤正确治疗了高雄激素血症，并避免了对肾上腺腺瘤进行不必要的手术。
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