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Virilizing mature ovarian cystic teratomas
A López-Beltrán1, A S Calanas, P Jimena
1Department of Pathology, Cordoba University Medical School and Reina Sofia University Hospital, Spain.
Virchows Archiv : an International Journal of Pathology
|August 1, 1997
Summary
Benign cystic teratomas of the ovary can cause virilization in postmenopausal women. Tumor removal normalized elevated androstenedione and testosterone levels, suggesting a link to ovarian stromal luteinization.
Area of Science:
- Gynecology
- Endocrinology
- Oncology
Background:
- Mature benign cystic teratomas, also known as dermoid cysts, are germ cell tumors that can rarely present with hormonal activity.
- Virilization, characterized by the development of male physical sex characteristics, can be caused by androgen-secreting tumors.
Observation:
- Three additional cases of virilization associated with ovarian cystic teratomas in postmenopausal, obese, diabetic women are reported.
- Patients presented with symptoms including hirsutism, voice changes, and clitoromegaly.
- Elevated serum testosterone and androstenedione levels were observed.
Findings:
- Surgical removal of the teratomas led to a prompt regression of hormonal abnormalities.
- Histological examination revealed stromal luteinized cells at the tumor-ovarian interface.
- The virilization is hypothesized to stem from luteinization of the ovarian stroma, potentially influenced by an unknown factor linked to diabetes mellitus.
Implications:
- This study highlights a rare cause of virilization in postmenopausal women, emphasizing the importance of considering ovarian tumors in the differential diagnosis.
- The findings suggest a potential interplay between diabetes mellitus, ovarian stromal changes, and androgen excess.
- Further research is warranted to elucidate the exact mechanism linking diabetes, stromal luteinization, and virilization in the context of ovarian teratomas.