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[Ovarian Leydig cell tumor].

S Vujović1, Z Penezić, M Drezgić

  • 1Institut za endokrinologiju, dijabetes i bolesti metabolizma, Klinicki centar Srbije, Beograd, Medicinski fakultet Univerziteta u Beogradu.

Medicinski Pregled
|April 26, 2001
PubMed
Summary

Leydig cell tumors are rare ovarian neoplasms producing excess testosterone, causing virilization symptoms. Surgical removal is the only effective treatment, leading to symptom resolution and hormone normalization.

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Area of Science:

  • Gynecologic Oncology
  • Reproductive Endocrinology
  • Oncopathology

Background:

  • Leydig cell tumors are rare sex cord-stromal ovarian neoplasms, accounting for <0.6% of ovarian tumors.
  • These tumors are characterized by excessive sexual steroid production, primarily testosterone.
  • They predominantly affect women around age 28.

Observation:

  • Tumors are typically solid, yellowish, and nodular, measuring <5 cm.
  • Histopathology reveals polygonal Leydig cells with eosinophilic cytoplasm, lipid vacuoles, and pleomorphic nuclei.
  • Associated hyperthecosis may be present around the tumor.

Findings:

  • Clinical presentation includes signs of hyperandrogenism such as hirsutism, clitoromegaly, and menstrual irregularities.
  • Hormonal analysis shows elevated testosterone, androstenedione, and 17 OH progesterone, with suppressed gonadotropins.

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  • Diagnostic imaging includes ultrasonography, MRI, and Doppler sonography; hCG stimulation tests confirm testosterone production.
  • Implications:

    • Surgical tumor excision is the definitive therapy for Leydig cell tumors.
    • Post-operative normalization of testosterone levels and gonadotropins is expected.
    • Complete resolution of clinical symptoms and signs follows successful surgical intervention.