Forte Angelo, D'Elia Lanfranco, De Luca Carmine, Fiore Antonella, Barbato Antonio, Abate Veronica, Vergatti Anita, Verde Nunzia, De Filippo Gianpaolo, Venetucci Pietro, De Angelis Maria Chiara, Di Crescenzo Rosa Maria, Grasso Francesca, Giuseppe Perruolo, Formisano Pietro, Di Spiezio Sardo Attilio, Pivonello Rosario, Rendina Domenico
Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy.
Service d'Endocrinologie et Diabétologie Pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Paris, France.
Front Endocrinol (Lausanne). 2025 Aug 1;16:1495930. doi: 10.3389/fendo.2025.1495930. eCollection 2025.
Postmenopausal hyperandrogenism (PH) is a rare clinical condition caused by relative or absolute androgen excess after menopause. Tumorous or non-tumorous ovarian diseases can cause PH.
In this two-section hybrid study, the first section describes the case of a patient with PH caused by an ovarian disease and surgically treated. The second section shows the results of a scoping review with individual patient data (IPD) analysis, which was performed to define the biochemical and clinical features of PH patients with tumorous or non-tumorous ovarian diseases surgically treated. All PH cases caused by anything but ovarian disease and/or without surgical indication and/or without histological diagnosis were excluded.
Due to imaging suspicion, our PH patient underwent robotic hysterectomy with bilateral ovariectomy. A Leydig cell tumor stage 1A was diagnosed. At 6 months after surgery, the PH was resolved. Overall, the IPD analysis included 280 PH patients with ovarian diseases (oPH) surgically treated. Among them, histological examination showed 174 tumorous oPH and 106 non-tumorous oPH. Patients with tumorous oPH showed lower body mass index and lower levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as higher levels of testosterone, dehydroepiandrosterone sulfate (DHEA-S), 17-OH progesterone, and estradiol compared with non-tumorous oPH patients. We defined the levels of testosterone (≥9.8 nmol/L), LH (≤15 mUI/ml), FSH (≤35 mUI/ml), and DHEA-S (≥1.6 μmol/L) able to differentiate between tumorous and non-tumorous oPH patients with suitable sensitivity (≥68.6%) and specificity (≥72.7%). No PH recurrence was described after surgery.
The study results provide useful biochemical parameters to support the diagnosis of ovarian tumor in patients with oPH.
绝经后高雄激素血症（PH）是一种罕见的临床病症，由绝经后相对或绝对雄激素过多引起。肿瘤性或非肿瘤性卵巢疾病可导致PH。
在这项两部分的混合研究中，第一部分描述了一名因卵巢疾病导致PH并接受手术治疗的患者的病例。第二部分展示了一项范围综述及个体患者数据（IPD）分析的结果，该分析旨在确定接受手术治疗的患有肿瘤性或非肿瘤性卵巢疾病的PH患者的生化和临床特征。所有由非卵巢疾病引起的和/或无手术指征的和/或无组织学诊断的PH病例均被排除。
由于影像学怀疑，我们的PH患者接受了机器人辅助子宫切除术及双侧卵巢切除术。诊断为1A期莱迪希细胞瘤。术后6个月，PH得到缓解。总体而言，IPD分析纳入了280例接受手术治疗的患有卵巢疾病的PH患者（oPH）。其中，组织学检查显示174例为肿瘤性oPH，106例为非肿瘤性oPH。与非肿瘤性oPH患者相比，肿瘤性oPH患者的体重指数较低，促黄体生成素（LH）和促卵泡生成素（FSH）水平较低，而睾酮、硫酸脱氢表雄酮（DHEA-S）、17-羟孕酮和雌二醇水平较高。我们确定了睾酮（≥9.8 nmol/L）、LH（≤15 mUI/ml）、FSH（≤35 mUI/ml）和DHEA-S（≥1.6 μmol/L）的水平，这些水平能够以合适的敏感性（≥68.6%）和特异性（≥72.7%）区分肿瘤性和非肿瘤性oPH患者。术后未描述有PH复发情况。
研究结果提供了有用的生化参数，以支持oPH患者卵巢肿瘤的诊断。
