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Rebecca J Brown, Jalaja Joseph, Elaine Cochran, Cornelia Gewert, Robert Semple, Phillip Gorden
CONTEXT: Hyperinsulinemia can lead to pathologic ovarian growth and androgen production. CASE DESCRIPTION: A 29 year old woman developed an autoantibody to the insulin receptor (Type B insulin resistance), causing extreme insulin resistance and hyperinsulinemia. Testosterone levels were elevated to the adult male range. Treatment with gonadotropin releasing hormone (GnRH) analog led to normalization of testosterone, despite persistent extreme insulin resistance...
December 2, 2016: Journal of Clinical Endocrinology and Metabolism
Cunxian Zhang, C James Sung, M Ruhul Quddus, Rochelle A Simon, Tarek Jazaerly, W Dwayne Lawrence
Ovarian hyperthecosis, a source of estrogen, may occur in postmenopausal women. In this study, we evaluated the possible association of ovarian hyperthecosis with endometrial polyp, endometrial hyperplasia, and endometrioid adenocarcinoma in postmenopausal women. Our study consisted of 238 postmenopausal women: 108 with endometrioid adenocarcinoma and 130 without endometrial carcinoma. The International Federation of Gynecology and Obstetrics system was used to grade endometrioid adenocarcinoma. Within the endometrioid adenocarcinoma cases, 48 (44...
January 2017: Human Pathology
Julie Carré, Solange Grunenwald, Delphine Vezzosi, Catherine Mazerolles, Antoine Bennet, Geri Meduri, Philippe Caron
CONTEXT: Oncocytic tumors of the adrenal cortex are rare, mostly nonfunctioning and benign. SETTING: Report virilizing oncocytic adrenocortical carcinoma in a 50-year-old woman. PATIENT: She presented a recent and progressive virilization syndrome, associated with high blood pressure. Hormonal evaluation showed elevated serum testosterone and delta-4-androstenedione levels, normal urinary free cortisol level and incomplete suppression of cortisol at the 1 mg dexamethasone suppression test...
August 2016: Gynecological Endocrinology
A H Dédjan, A Chadli, S El Aziz, A Farouqi
Introduction. Female hyperandrogenism is a frequent motive of consultation. It is revealed by hirsutism, acne or seborrhea, and disorders in menstruation cycle combined or not with virilisation signs. Several etiologies are incriminated but the hyperandrogenism-insulin resistance-acanthosis nigricans syndrome is rare. Observation. A 20-year-old girl, having had a five-year-old secondary amenorrhea. The exam revealed a patient, normotensive with a body mass index at 30 kg/m(2) and a waist measurement of 120 cm, a severe hirsutism assessed to be 29 according to Ferriman Gallwey scale, virilisation signs of male morphotype, clitoridic hypertrophy and frontal alopecia, and an acanthosis nigricans behind the neck, in the armpits and elbows...
2015: Case Reports in Endocrinology
Farideh Zafari Zangeneh, Alireza Abdollahi, Fatemeh Aminee, Mohammad Mahdi Naghizadeh
BACKGROUND: "Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder associated with ovulatory dysfunction". "Autonomic and central nervous systems play important roles in the regulation of ovarian physiology". The noradrenergic nucleus locus coeruleus (LC) plays a central role in the regulation of the sympathetic nervous system and synaptically connected to the preganglionic cell bodies of the ovarian sympathetic pathway and its activation is essential to trigger spontaneous or induced LH surges...
March 2012: Iranian Journal of Reproductive Medicine
Santosh Kumar, Swati Agrawal, Kumar Jayant, Sriharsha Ajjoor Shankargowda
INTRODUCTION: Clitromegaly can be congenital or acquired with the former type being more prevalent. The main etiology behind the acquired type is hormonal imbalance affecting mainly adult women. This type is seen mostly in association with polycystic ovarian syndrome, hyperthecosis, ovarian tumors, and clitoral cysts or it can be drug-induced. Clitoral leiomyoma is a rare benign tumor of female genitalia and is an uncommon cause of clitromegaly. CASE REPORT: We reported a 42-year-old premenopausal woman with a progressively increasing mass since five years ago, who had attended our clinic with urinary retention...
May 2014: Nephro-urology Monthly
Sinan Beksac, Ilker Selçuk, Gökhan Boyraz, Güneş Güner, Mert Turgal, Alp Usubutun
It is important to define the aetiology of increased levels of androgens in women. Ovarian stromal hyperplasia (OSH) and ovarian hyperthecosis (OHT) are non-neoplastic pathologies. They show the excess of androgen production and have a wide clinical range like hirsutism, virilisation, abnormal menses, obesity, hypertension and insulin resistance. Ovarian stromal hyperplasia and hyperthecosis are commonly seen in postmenopausal women and generally involve both ovaries. Laboratory testing is the gateway; testosterone and dehydroepiandrosterone sulphate (DHEA-S) are the first hormones that should be measured...
2013: Journal of the Turkish German Gynecological Association
Caitlin Dunne, Jon C Havelock
Sertoli-Leydig cell tumors (SLCT) are rare, comprising less than 0.5% of ovarian neoplasms. They are most often diagnosed in premenopausal women and may produce androgens, resulting in hirsuitism, voice deepening, frontal balding, terminal hair growth, and clitoromegaly. SLCT are malignant in 15%-20% of cases. We discuss a 25-year-old patient with persistent hyperandrogenemia. Noninvasive imaging cannot conclusively differentiate between SCLT and other diagnoses such as polycystic ovary syndrome, ovarian hyperthecosis, idiopathic hyperandrogenism, idiopathic hirsuitism, and 21-hydroxylase-deficient nonclassic adrenal hyperplasia...
November 2012: Journal of Minimally Invasive Gynecology
Elena García, Víctor García-Hierro, Laura De La Maza, Pilar Alvarez, Estefanía Santos, Javier Pi, Luis Castillo, Enrique Ruiz
Ovarian androgen hypersecretion is a wellrecognized cause of hirsutism and virilization in postmenopausal women. Postmenopausal ovarian hyperthecosis is a nonneoplastic functional disorder, which results from abnormal regulation of ovarian steroidogenesis. We present a patient with postmenopausal hyperandrogenism due to ovarian hyperthecosis.
October 2008: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
Qi Wang, Ji Young Kim, Kai Xue, Jia-yin Liu, Arthur Leader, Benjamin K Tsang
Polycystic ovarian syndrome (PCOS) is a heterogeneous syndrome associated with follicle growth arrest, minimal granulosa cell proliferation, dysregulated sex hormone profile, hyperthecosis, and insulin resistance. Using a 5α-dihydrotestosterone (DHT)-induced rat model that recapitulates the reproductive and metabolic phenotypes of human PCOS, we have examined the steroidogenic capability of granulosa cells from DHT-treated rats. Gene expression of several key steroidogenic enzymes including p450 side-chain cleavage enzyme (p450scc), aromatase, steroidogenic acute regulatory protein, hydroxysteroid dehydrogenase-17β, and hydroxysteroid dehydrogenase-3β were markedly lower in DHT-treated rats than the controls, although the responsiveness of their granulosa cells to FSH was higher...
November 2012: Endocrinology
Macarena Alpañés, José M González-Casbas, Juan Sánchez, Héctor Pián, Héctor F Escobar-Morreale
CONTEXT: Mild clinical signs of hyperandrogenism such as hirsutism may appear during the menopausal transition as part of the normal aging process, but the development of frank virilization suggests a specific source of androgen excess, including androgen-secreting tumors. PATIENT AND METHODS: A 68-yr-old postmenopausal woman was referred because of a history of progressive development of hirsutism and frontal balding for the previous 8 yr, together with moderate hyperandrogenemia...
August 2012: Journal of Clinical Endocrinology and Metabolism
A-L Castell, S Hieronimus, A Chevallier, J-L Sadoul, M-B Galand-Portier, J Delotte, P Fénichel
Ovarian hyperthecosis is infrequent but it represents the first cause of post-menopausal hyperandrogenia. Pathophysiology of ovarian hyperthecosis remains poorly understood but the metabolic syndrome observed in most patients suggests that insulin resistance associated with high, postmenopausal LH levels, might play a role as in polycystic ovarian syndrome. We report here four patients who presented post-menopausal hyperandrogenia. Although high, tumoral, plasma testosterone levels, lack of focused radiological lesions except enlarged ovaries, associated to the metabolic syndrome, suggested ovarian hyperthecosis...
May 2012: Gynécologie, Obstétrique & Fertilité
Richard C Kline, Lisa B Bazzett-Matabele
In this article, the authors review both benign and malignant ovarian masses, as the colorectal surgeon who encounters an adnexal mass at the time of surgery should be aware of the steps necessary for surgical staging and optimal tumor resection.Ovarian tumors-most of which are benign-are divided into three major categories, in order of frequency: epithelial, germ cell, and sex cord-stromal tumors. Nonneoplastic conditions of the ovary that may present as adnexal masses include the following, according to World Health Organization (WHO) classification: pregnancy luteoma, hyperplasia of ovarian stroma, hyperthecosis, massive edema, solitary follicle cysts and corpus luteal cysts, multiple follicle cysts, and endometriosis...
June 2010: Clinics in Colon and Rectal Surgery
K Ashawesh, M M Aghilla, H S Randeva
No abstract text is available yet for this article.
May 2011: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Esther S Vollaard, André P van Beek, Frederik A J Verburg, Annemieke Roos, Jolande A Land
CONTEXT: The most frequent cause of virilization in postmenopausal women is excessive androgen production of ovarian origin. Bilateral oophorectomy is usually performed, even in cases of benign tumors or hyperthecosis. This is the first report of a case series of long-term GnRH-agonist treatment of hyperandrogenism in postmenopausal women. OBJECTIVE: We present three women with postmenopausal hyperandrogenism of ovarian origin who were treated with GnRH agonists...
May 2011: Journal of Clinical Endocrinology and Metabolism
M Pugeat, H Déchaud, V Raverot, A Denuzière, R Cohen, P Boudou
1. Total testosterone assay is recommended as the first-line approach. 2. Radioimmunological assay following prior treatment of the sample (extraction or extraction + chromatography) is the recommended method pending wider experience with mass spectrometry. 3. Where testosterone is twice the upper limit of normal, it is recommended that DHEAS assay be performed. DHEAS is primarily of cortico-adrenal origin in women. Thus, a DHEAS level over 600 mg/dl indicates a diagnosis of androgen-secreting adrenal cortical adenoma...
February 2010: Annales D'endocrinologie
Andrew B Rosenkrantz, Dorota Popiolek, Genevieve L Bennett, Elizabeth M Hecht
Ovarian stromal hyperplasia and ovarian hyperthecosis are non-neoplastic conditions of the ovary associated with clinical manifestations of hyperandrogenism from ovarian production of male hormones. In this article, we present the first published cases of the magnetic resonance imaging appearance of these conditions, which may mimic that of ovarian neoplasm. In contrast to bilateral ovarian vein sampling, magnetic resonance imaging may provide a noninvasive means of suggesting a diagnosis of ovarian stromal hyperplasia/ovarian hyperthecosis when a hormone-secreting ovarian neoplasm is suspected clinically and thereby may assist in identifying patients who may be effectively treated nonsurgically with gonadotrophin-releasing hormone therapy...
November 2009: Journal of Computer Assisted Tomography
Michael Conall Dennedy, Diarmuid Smith, Donal O'Shea, T Joseph McKenna
Approximately 7% of women of reproductive age manifest polycystic ovary syndrome (PCOS) and <0.5% have other causes of hyperandrogenism including congenital adrenal hyperplasia (CAH), androgen-secreting tumour of an ovary or an adrenal gland, Cushing's syndrome or hyperthecosis. The presence of features atypical of PCOS should prompt more extensive evaluation than that usually undertaken. Features atypical of PCOS include the onset of symptoms outside the decade of 15-25 years, rapid progression of symptoms, the development of virilization and a serum testosterone concentration in excess of twice the upper limit of the reference range...
February 2010: European Journal of Endocrinology
Annette Bühler-Christen, Verena Tischler, Pierre-André Diener, Michael Brändle
Recent onset of hirsutism in postmenopausal women is mostly caused by androgen secretion from adrenal or ovarian tumours. Ovarian hyperthecosis (OH) is a cause of hyperandrogenism in premenopausal women, few cases of postmenopausal presentation have been described. We report on a 73-year old women with androgenic alopecia and hirsutism of recent onset because of elevated testosterone levels. Radiologic imaging showed no tumours of the adrenal glands and ovaries. Careful re-evaluation revealed increased ovarian size in relation to age...
May 2009: Gynecological Endocrinology
S Fujii, T Kiyokawa, S Tsukihara, T Senda, T Tahara, T Kaminou, T Ogawa
Ovarian stromal hyperthecosis is characterized by diffuse distribution of luteinized stromal cells accompanied by varying degrees of stromal hyperplasia. We report a case of ovarian stromal hyperthecosis with particular regard to magnetic resonance (MR)-pathologic correlation. At initial MR imaging, the central areas of the bilateral ovarian masses showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images, while the peripheries of the bilateral masses showed isointensity to myometrium on T1-weighted images and heterogeneous signal intensities on T2-weighted images...
October 2009: Acta Radiologica
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