Postmenopausal women with hyperandrogenemia: Three case reports.

Area of Science:

• Endocrinology
• Gynecologic Oncology
• Radiology

Background:

• Diagnosing hyperandrogenemia in postmenopausal women presents significant challenges, often leading to misdiagnosis or delayed detection.
• Ovarian steroid cell tumors are rare, accounting for approximately 0.1% of all ovarian tumors, contributing to a lack of typical imaging findings.
• The subtle or absent clinical manifestations of hyperandrogenemia in postmenopausal women complicate early identification.

Observation:

• Three postmenopausal women with hyperandrogenemia were evaluated, with only one exhibiting virilization symptoms.
• Two patients were asymptomatic, underscoring the often-silent nature of these tumors.
• Histological examination revealed one Leydig cell tumor and two benign, non-specific steroid cell tumors.

Findings:

• Ovarian steroid cell tumors can present asymptomatically, despite elevated serum testosterone levels.
• Typical imaging features include a solid, slightly hypoechoic, round or oval mass with uniform internal echo, prominent vascularity, and a low resistance index.
• Surgical intervention confirmed the diagnosis and effectively treated the condition in all reported cases.

Implications:

• Accurate diagnosis of ovarian steroid cell tumors in postmenopausal women requires a comprehensive approach integrating clinical and imaging data.
• Early detection and surgical management offer a definitive treatment for hyperandrogenemia caused by these rare ovarian neoplasms.
• Further research into characteristic imaging findings can improve the diagnostic accuracy for these uncommon tumors.