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首页> 外文期刊>Gynecological endocrinology: the official journal of the International Society of Gynecological Endocrinology >Hyperandrogenism in post-menopausal women: A diagnosis challenge
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Hyperandrogenism in post-menopausal women: A diagnosis challenge

机译：绝经后女性的高雄激素血症：诊断挑战

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A 79-year-old woman, presented with increased hair growth in the chin and the upper lip but no in other androgen-dependent areas of her body. Hormonal evaluation showed markedly elevated serum testosterone level (>1.7 ng/ml) and normal DHEA-S, androstenedione, 17-hydroxyprogesterone, cortisol and TSH levels. The diagnosis of probable pure testosterone secreting tumor was made. Transvaginal ultrasound and magnetic resonance image revealed a 16 mm × 12 mm nodular formation indicative of an atypical adenoma in the left adrenal gland and a tube-shaped, fluid-filled, thin-walled image measuring 28 mm × 14 mm suggestive of a hydrosalpinx in the right ovary. Differential diagnosis between the coexistence of an androgen-producing ovarian tumor (occult) associated with a finding of an adrenal image (Incidentaloma) or an adrenal tumor secreting testosterone only was done. Since cortisol levels went down, but total testosterone inhibition did not occur after suppression with dexamethasone. An ovarian androgen secreting tumour was suspected and surgery was performed. Histological examination showed a Leydig cells hyperplasia. After the operation testosterone returned to normal with regression of clinical symptoms.
机译：一位79岁的女性，下巴和上唇的毛发生长增加，但身体其他依赖雄激素的区域则没有。激素评估显示血清睾丸激素水平（> 1.7 ng / ml）和正常DHEA-S，雄烯二酮，17-羟基孕酮，皮质醇和TSH水平显着升高。诊断可能是纯睾丸激素分泌肿瘤。经阴道超声和磁共振图像显示出16 mm×12 mm的结节状结节，表明左肾上腺为非典型腺瘤，管形，充满液体的薄壁图像尺寸为28 mm×14 mm，提示存在输卵管积水。右卵巢。在产生雄激素的卵巢肿瘤（隐匿性）与发现肾上腺图像（偶然性瘤）或仅分泌睾丸激素的肾上腺肿瘤相关的共存之间进行了鉴别诊断。由于皮质醇水平下降，但是地塞米松抑制后总的睾丸激素抑制作用并未发生。怀疑有卵巢分泌雄激素的肿瘤，并进行了手术。组织学检查显示间质细胞增生。术后睾丸激素恢复正常，临床症状消退。

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