绝经后妇女隐匿性症状性双侧单纯莱迪希细胞瘤：病例报告。
Occult symptomatic bilateral pure Leydig cell tumors in a postmenopausal woman: a case report.
机构信息
Department of Obstetrics and Gynecology, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
Division of Gynecologic Oncology, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
出版信息
Gynecol Endocrinol. 2021 Jul;37(7):672-675. doi: 10.1080/09513590.2021.1934443. Epub 2021 Jun 17.
BACKGROUND
Pure Leydig cell tumors (LCTs) represent 0.1% of ovarian masses. Postmenopausal patients typically present with virilization. Although LCTs can be challenging to locate on conventional imaging, positron emission tomography (PET) has been demonstrated to be effective.
CASE
A 64-year-old postmenopausal woman presented with alopecia, facial hirsutism, and clitoromegaly. Laboratory findings included elevated testosterone and androstenedione. Ultrasound, computed tomography, and magnetic resonance imaging showed no adnexal masses. PET did not demonstrate ovarian fludeoxyglucose-avidity. Histopathology after bilateral salpingo-oophorectomy revealed bilateral Leydig cell tumors. Her testosterone normalized 2 weeks postoperatively.
CONCLUSION
We describe the occult, symptomatic, bilateral ovarian Leydig cell tumors, an occurrence that has not been described in the literature. Virilizing tumors must be considered in patients with evidence of hyperandrogenism, even without pelvic masses on imaging.
背景
单纯型睾丸间质细胞瘤（LCT）占卵巢肿块的 0.1%。绝经后患者通常表现为男性化。虽然 LCT 在常规影像学上难以定位，但正电子发射断层扫描（PET）已被证明是有效的。
病例
一名 64 岁绝经后妇女出现脱发、面部多毛和阴蒂肥大。实验室检查发现睾酮和雄烯二酮升高。超声、计算机断层扫描和磁共振成像均未显示附件肿块。PET 未显示卵巢氟脱氧葡萄糖摄取活性。双侧输卵管卵巢切除术后的组织病理学显示双侧睾丸间质细胞瘤。术后 2 周，她的睾酮恢复正常。
结论
我们描述了隐匿性、症状性双侧卵巢睾丸间质细胞瘤，这种情况在文献中尚未描述。有雄激素过多证据的患者必须考虑有男性化作用的肿瘤，即使影像学上没有盆腔肿块。
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