Virilization of a postmenopausal woman by a mucinous cystoadenoma

To describe the case of the most hyperandrogenaemic ovarian mucinous cystadenoma reported to date.

We present the clinical, laboratory and radiologic findings in a patient with an unusual diagnosis according to age and the clinical behaviour of the tumour, as well as a review of relevant literature.

A 77-year-old women came to our consult because of fronto-parietal alopecia and an augmentation of the abdominal perimeter since 1 year ago. Clitoromegaly was observed during the physical examination. Hormonal analysis showed elevated testosterone and dehydroepiandrostenerone-sulphate levels (659 ng/dL and 1950 ng/ml, respectively), and imaging examination described an andexal cystic mass dependent on the right ovary. Pathological diagnosis was "mucinous cystoadenoma". After surgery, clinical and analytical alterations were normalized.

Although ovarian mucinous cystadenomas are classically classified as "nonfunctional" tumours, they exceptionally can act as functional, and produce testosterone levels as high as directly secreting hormones or germ cell tumours.