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卵巢成人颗粒细胞瘤中睾酮升高:病例报告及文献复习。

Testosterone elevation in ovarian adult granulosa cell tumor: A case report and review of the literature.

机构信息

Department of Gynecology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

出版信息

Medicine (Baltimore). 2023 May 12;102(19):e33763. doi: 10.1097/MD.0000000000033763.

Abstract

RATIONALE

Adult granulosa cell tumors (AGCT) mainly secret estrogen, but few androgens. It is rarer to have amenorrhea and hyperandrogenemia as clinical features. Here, we report a rare case of right side AGCTs with amenorrhea and hyperandrogenemia in a 19-year-old female.

PATIENT CONCERNS

The 19-year-old patient was admitted to our hospital due to amenorrhea for more than 1 year, and discovery of pelvic mass for 4 months. The gynecological ultrasound and computed tomography (CT) cannot define the nature of the mass. Surprisingly, an elevation in testosterone levels was also measured.

DIAGNOSIS AND INTERVENTIONS

The present patient underwent laparoscopic right salpingo-oophorectomy and partial omentectomy and biopsy of the peritoneum.

OUTCOMES

After the surgery, the testosterone value was down to normal. The patient menstrual cramps on August 13, 2021. Her clitoris is smaller than the front. Up to August 1, 2022, there was no obvious sign of recurrence.

LESSONS

Androgen-secreting AGCT is rare. We hope that this case can strengthen gynecologists' early diagnosis and treatment of this disease and improve the prognosis.

摘要

背景

成人颗粒细胞瘤(AGCT)主要分泌雌激素,但雄激素分泌较少。以闭经和高雄激素血症为临床特征的情况较为少见。本文报道了 1 例罕见的右侧 AGCT 伴闭经和高雄激素血症的 19 岁女性病例。

患者关注

19 岁患者因闭经 1 年以上,盆腔肿块 4 个月,就诊于我院。妇科超声和计算机断层扫描(CT)不能确定肿块的性质。令人惊讶的是,还测量到睾酮水平升高。

诊断与干预

本患者接受了腹腔镜右侧输卵管卵巢切除术和部分网膜切除术及腹膜活检。

结果

术后,睾酮值降至正常。患者于 2021 年 8 月 13 日出现月经来潮。其阴蒂小于前部。截至 2022 年 8 月 1 日,无明显复发迹象。

教训

雄激素分泌性 AGCT 较为罕见。我们希望这个病例能够加强妇科医生对这种疾病的早期诊断和治疗,改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0836/10174397/d891438f457c/medi-102-e33763-g001.jpg

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