Chico A, García J L, Matías-Guiu X, Webb S M, Rodríguez J, Prat J, Calaf J
Department of Endocrinology, Hospital de la Santa Cruz y San Pablo, Autonomous University, Barcelona, Spain.
Clin Endocrinol (Oxf). 1995 Nov;43(5):645-9. doi: 10.1111/j.1365-2265.1995.tb02931.x.
A stromal luteoma is an uncommon ovarian tumour in post-menopausal women, which presents rarely with hyperandrogenism and virilization. We present the case of a 64-year-old woman referred for evaluation of virilization which had developed over 5 years. Testosterone, FSH and LH were markedly inhibited following the administration of a GnRH analogue, suggesting a gonadotrophin dependent, testosterone secreting ovarian tumour, which could not be localized with imaging techniques. Surgery revealed normal sized ovaries with no apparent lesions, but microscopic examination showed a small stromal luteoma in the right ovary and severe stromal hyperthecosis in the adjacent and contralateral ovarian stroma. We conclude that stromal luteoma is an uncommon cause of virilization in post-menopausal women. This case illustrates, to our knowledge for the first time, that a stromal luteoma is not autonomous but is gonadotrophin dependent.
间质黄体瘤是绝经后女性中一种罕见的卵巢肿瘤，很少表现为高雄激素血症和男性化。我们报告一例64岁女性，因评估5年来出现的男性化症状前来就诊。给予促性腺激素释放激素类似物后，睾酮、促卵泡生成素和促黄体生成素明显受到抑制，提示存在一种依赖促性腺激素、分泌睾酮的卵巢肿瘤，而影像学检查无法定位该肿瘤。手术发现卵巢大小正常，无明显病变，但显微镜检查显示右侧卵巢有一个小的间质黄体瘤，相邻及对侧卵巢间质有严重的间质卵泡膜细胞增生。我们得出结论，间质黄体瘤是绝经后女性男性化的罕见原因。据我们所知，该病例首次表明间质黄体瘤并非自主性的，而是依赖促性腺激素的。
