ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P305

A rare case of hiperandrogenism bilateral Leydig cell tumor of the ovary

Mafalda Marcelino, Ema Lacerda Nobre, João Conceição, Arlindo Carvalho, Ana Paula Horta & João Jácome de Castro


Hospital Militar Principal, Lisboa, Portugal.


Background: The androgen-secreting tumors constitute fewer than 1% of ovarian tumors. Leydig cell tumor is one of the most common of this type of lesion and it is usually benign, small and unilateral.

Case report: A 67-year-old women was referred to the Endocrine clinic due to hirsutism (score 22 Ferriman–Gallwey) and male type alopecia with 3 years of evolution and progressive worsening. Biochemically she had high levels of serum testosterone – 662 ng/dl (N<62 ng/dl). Transvaginal ultrassonography, and abdomen–pelvic CT scan didn’t show any signs of adrenal or ovarian tumors. Bilateral oophorectomy was performed and histopathologic exam revealed bilateral Leydig cell tumors, measuring 1 cm each. Four months after surgery, the patient had a marked improvement of the signs (score 3 Ferriman–Gallwey) and normalized testosterone levels (35.9 ng/dl).

Discussion: Androgen-secreting tumors are rare, but they should be excluded in cases of rapid onset of virilization and elevated androgen levels. Tumors are frequently undetectable by imaging techniques because of their small dimensions. Exploratory surgery by a skilled team is frequently necessary and is often the best treatment for the majority of these cases. We present a rare case of bilateral Leydig cell tumor. Only five cases have been reported in the literature. The clinical history and the elevated levels of testosterone had suggested the presence of an androgen-producing tumor. Attempting to the fact that our patient was in a post-menopausal stage, we decided that the appropriate treatment would be bilateral oophorectomy. The histopathologic disclosed the diagnosis and allowed the patient’s cure.

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