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Asymmetric hyperthecosis ovarii

M Farber, A Madanes, D S O'Briain

    Obstetrics and Gynecology
    |April 1, 1981
    PubMed
    Summary
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    This study identified the left ovary as the primary source of excess androgens in a virilized female using venous catheterization. Accurate preoperative diagnosis is crucial for successful surgical treatment of androgen excess.

    Area of Science:

    • Endocrinology
    • Reproductive Medicine
    • Surgical Diagnosis

    Background:

    • Virilization in women can stem from androgen excess.
    • Identifying the specific source of androgen overproduction is critical for effective management.
    • Ovarian and adrenal vein catheterization is a diagnostic tool for localizing androgen hypersecretion.

    Purpose of the Study:

    • To pinpoint the predominant androgen-secreting source in a virilized female patient.
    • To evaluate the efficacy of selective venous catheterization in preoperative diagnosis.
    • To correlate biochemical findings with histological examination of ovarian tissue.

    Main Methods:

    • Percutaneous retrograde femoral catheterization of ovarian and adrenal veins bilaterally.
    • Measurement of testosterone and delta4-androstenedione concentrations in collected venous blood.

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  • Histologic examination of surgically excised ovarian tissue.

    • Main Results:

    • The left ovary was confirmed as the predominant source of androgens.
    • Asymmetric hyperthecosis ovarii was identified in the excised ovarian tissue.
    • Biochemical data from venous sampling accurately predicted the histological findings.

    Conclusions:

    • Selective venous catheterization is an accurate method for preoperative localization of androgen hypersecretion.
    • Accurate preoperative diagnosis is vital for successful surgical intervention in virilized women.
    • Surgical correction led to a favorable clinical outcome, highlighting the importance of precise diagnosis.