Czyzyk Adam, Latacz Justyna, Filipowicz Dorota, Podfigurna Agnieszka, Moszynski Rafal, Jasinski Piotr, Sajdak Stefan, Gaca Michal, Genazzani Andrea R, Meczekalski Blazej
a Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland.
b Students Scientific Association of the Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland.
Gynecol Endocrinol. 2017 Nov;33(11):836-839. doi: 10.1080/09513590.2017.1337094. Epub 2017 Jun 11.
Ovarian hyperthecosis (OH) is characterized by the presence of abundant luteinized theca cells in ovaries that secret androgen. It typically presents as severe hyperandrogenism and/or virilization in postmenopausal woman. Here we describe a 66-year old woman with presentation of severe hirsutism, alopecia, clitoromegaly and laboratory finding of significantly elevated serum total testosterone concentration and hyperinsulinemia. Performed imaging studies revealed normal sized, homogeneous ovaries, signs of endometrial hypertrophy and normal adrenal glands. Due to severe hyperandrogenemia and signs of endometrial hypertrophy, the total abdominal hysterectomy with bilateral salpingo-oophorectomy has been performed. Pathological examination revealed OH and endometrial hyperplasia. Androgenic activity of ovarian stromal cells has been confirmed using alpha-inhibin histochemical staining. Postmenopausal hyperandrogenemia is a diagnostic and therapeutic challenge and the imaging studies often may be misleading and require careful and critical consideration.
卵巢泡膜细胞增生症（OH）的特征是卵巢中存在大量分泌雄激素的黄素化泡膜细胞。它通常表现为绝经后女性严重的高雄激素血症和/或男性化。在此，我们描述一名66岁女性，其表现为严重多毛、脱发、阴蒂肥大，实验室检查发现血清总睾酮浓度显著升高和高胰岛素血症。影像学检查显示卵巢大小正常、均匀，有子宫内膜肥厚的迹象，肾上腺正常。由于严重的高雄激素血症和子宫内膜肥厚的迹象，已实施了全腹子宫切除术及双侧输卵管卵巢切除术。病理检查显示为卵巢泡膜细胞增生症和子宫内膜增生。使用α-抑制素组织化学染色证实了卵巢基质细胞的雄激素活性。绝经后高雄激素血症是一个诊断和治疗难题，影像学检查常常可能产生误导，需要仔细审慎地考虑。
