Endocrine profile of an ovarian androblastoma

The endocrine profile of a 16-year-old girl with an androblastoma of the left ovary is presented. Calculated ratios of steroid hormones between the intraoperative peripheral vein blood, the left ovarian vein blood, and the left ovarian tumor fluid were progesterone, 1:10.2:39.5; 17-hydroxyprogesterone, 1:18.7:64.7; dehydroepiandrosterone (DHEA), 1:10.4:35.6; androstenedione (A), 1:24.4:92.3; testosterone (T), 1:18.6:69.2; and estradiol (E2), 1:11.0:26.3. The peripheral levels of hormones before left salpingo-oophorectomy were T, 7.5 ng/ml; DHEA, 19.9 ng/ml; A, 12.3 ng/ml; and cortisol, 11.4 micrograms/dl. Corresponding levels at 14 days after surgery were (0.75 ng/ml; 5.84 ng/ml; 1.94 ng/ml; and 15.6 micrograms/dl, respectively. Preoperatively, an elevated basal level of luteinizing hormone (LH) and a normal basal level of follice-stimulating hormone (FSH) (high LH:FSH ratio) were found. These data suggest that 1) androgens from the androblastoma are responsible for virilization despite aromatizing enzyme activities within normal limits, and 2) both the delta 5 and delta 4 pathways are involved in the biosynthesis of androgens, with that of delta 5 being predominant.