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Hyperandrogenism in a postmenopausal woman presenting with a metastatic ileum endocrine tumor
Anne Bachelot1, Geri Meduri, Eric Baudin
1Department of Endocrinology and Reproductive Medicine, Hôpital Necker, Paris, France.
Objective:
To elucidate the mechanism of the hyperandrogenism found in a postmenopausal woman presenting an ileum endocrine tumor with ovarian metastases.
Design:
Case report.
Setting:
University hospital.
Patient(S):
A postmenopausal woman was referred for hirsutism. Basal plasma testosterone was high, 6.6 nM/L (normal,
Intervention(S):
Bilateral salpingo-oophorectomy was performed. Pathological examination found a bilateral metastatic endocrine ovarian tumor, associated with a functional stroma. A primary ileum endocrine tumor was discovered and resected.
Main Outcome Measure(S):
Immunohistochemical study of the expression of steroidogenic enzymes and beta and alpha subunits of hCG.
Result(S):
Immunohistochemical expression of steroidogenic enzymes was found in the ovarian stromal tissue surrounding the tumor but not in the metastatic tumoral cells. A substantial percentage of the metastatic tumoral cells was immunopositive for the beta and alpha subunit of hCG but not the ileal cells.
Conclusion(S):
These data suggest an hCG paracrine effect of the ovarian metastases tumor on the adjacent interstitial cells, resulting in the virilization of the patient.