Oride Aki, Kanasaki Haruhiko, Okada Hiroe, Kyo Satoru
Department of Obstetrics and Gynecology, School of Medicine, Shimane University, 89-1 Enya Cho, Izumo, Shimane 693-8501, Japan.
Case Rep Womens Health. 2021 Feb 11;30:e00298. doi: 10.1016/j.crwh.2021.e00298. eCollection 2021 Apr.
A 39-year-old woman (gravida 1, para 1) was referred to a university hospital with a high serum testosterone level and secondary amenorrhea, hirsutism, and weight gain. Her voice was deep, and hirsutism was observed on her chin, arms, and back. She also had clitoromegaly. Her serum testosterone levels were markedly elevated (testosterone 11.1 ng/mL, free testosterone 15.5 pg/mL). Transvaginal ultrasonography and magnetic resonance imaging did not reveal any tumors in the pelvic organs, including the uterus and ovaries. Enhanced computed tomography revealed no abnormalities in either adrenal gland. Blood sampling from the inferior vena cava, left renal vein, and the ovarian veins on both sides revealed an extremely high testosterone level (391 ng/mL) in blood from the right ovarian vein. Laparoscopic right oophorectomy was performed and the pathologic diagnosis was a Leydig cell tumor (1.5 × 1.5 × 1.3 cm). Her serum testosterone level decreased rapidly following oophorectomy (0.3 ng/mL on postoperative day 2). Her menstrual cycle had recovered spontaneously by 2 months after surgery and she noticed improvement in the hirsutism 4 months after the operation.
一名39岁女性（孕1产1）因血清睾酮水平升高、继发性闭经、多毛症和体重增加被转诊至一家大学医院。她声音低沉，下巴、手臂和背部出现多毛症。她还患有阴蒂肥大。她的血清睾酮水平显著升高（睾酮11.1 ng/mL，游离睾酮15.5 pg/mL）。经阴道超声检查和磁共振成像未发现盆腔器官（包括子宫和卵巢）有任何肿瘤。增强计算机断层扫描显示双侧肾上腺均无异常。从下腔静脉、左肾静脉和双侧卵巢静脉采血显示，右侧卵巢静脉血中的睾酮水平极高（391 ng/mL）。进行了腹腔镜下右侧卵巢切除术，病理诊断为睾丸间质细胞瘤（1.5×1.5×1.3 cm）。卵巢切除术后她的血清睾酮水平迅速下降（术后第2天为0.3 ng/mL）。术后2个月她的月经周期自发恢复，术后4个月她注意到多毛症有所改善。
