绝经后妇女双侧显微镜下睾丸间质细胞瘤。
Bilateral microscopic Leydig cell ovarian tumors in the postmenopausal woman.
机构信息
University of New England College of Osteopathic Medicine, Biddeford, Maine, USA
Department of Obstetrics and Gynecology, Southern New Hampshire Medical Center, Nashua, New Hampshire, USA.
出版信息
BMJ Case Rep. 2020 Dec 22;13(12):e236427. doi: 10.1136/bcr-2020-236427.
A 64-year-old postmenopausal female patient presented with approximately 5 years of intermittent spotting, progressive hirsutism and significantly increased libido and clitoral hypersensitivity with spontaneous orgasms multiple times a day beginning a few months prior. Initial hormone work-up revealed elevated total serum testosterone, androstenedione and 17-hydroxyprogesterone. Luteinising hormone, follicle stimulating hormone, estradiol, dehydroepiandrosterone-sulfate, thyroid stimulating hormone and prolactin were all within normal limits. Initial suspicions suggested an androgen-secreting tumour, likely in the ovary. The lesion was undetectable on transvaginal ultrasound and abdominal-pelvic CT scan. Laparoscopic bilateral salpingo-oophorectomy was performed to remove the likely source of excess androgens. Visible gross lesions were not observed intraoperatively; however, bilateral Leydig (hilus cell) tumours were confirmed by histopathology. Serum testosterone, androstenedione and 17-hydroxyprogesterone levels were normalised postoperatively within 2 weeks and 1 month, respectively.
一位 64 岁绝经后女性患者出现间歇性点滴状出血约 5 年，多毛症进行性加重，性欲显著增加，阴蒂敏感性增加，自发性每日多次性高潮，始于数月前。初步激素检查显示总血清睾酮、雄烯二酮和 17-羟孕酮升高。促黄体生成素、促卵泡生成素、雌二醇、硫酸脱氢表雄酮、促甲状腺激素和催乳素均在正常范围内。最初怀疑是卵巢分泌雄激素的肿瘤。经阴道超声和腹部盆腔 CT 扫描均未发现病变。腹腔镜双侧输卵管卵巢切除术用于切除可能导致过多雄激素的来源。术中未观察到明显的大体病变；然而，组织病理学证实双侧莱迪希细胞瘤（门细胞）。术后 2 周和 1 个月，血清睾酮、雄烯二酮和 17-羟孕酮水平分别正常化。
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