[Stromal leydig cell tumor coexisting with ascites]

The stromal Leydig cell tumour (SLCT), a very rare, benign neoplasm was described in 75-year old woman. The patient presented the typical signs of virilisation (hirsutism, masculine alopecia, moderate clitoris enlargement, deep voice) as well as hypertension and insulin independent type of diabetes mellitus (IIDM). Additionally, she had marked ascites (3400 ml as established during surgery). The serum concentration of testosterone before the surgery was elevated up to 7.6 ng/ml. FSH and LH were at very low range (2.5 mIU/ml, 3.4 mIU/ml, respectively) whereas 17 beta-oestradiol was elevated (56 pg/ml). Total abdominal hysterectomy with salpingo-oophorectomy (TAH/BSO) and omentectomy were performed. The histopathological findings revealed stromal Leydig cell tumour with Reinke crystalloids. The postoperative follow-up was complicated by venous thrombosis. Five weeks after the surgery only slight regression of the signs of virilisation was observed. Hormonal findings were adequate to the patient age range (FSH--16.7 mIU/ml, LH--21.1 mIU/ml, testosterone--0.19 ng/ml, 17 beta-oestradiol concentration below 10 pg/ml).