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abstract
Hyperandrogenism
is a common finding in premenopausal age and is generally caused by
polycystic ovarian syndrome or other benign disease. Androgen-secreting
tumors represent only 0.2 % of the causes of hyperandrogenism and
usually present with severe clinical features, abrupt onset, and very
high androgens levels. We describe here three cases of occult ovarian
Leydig cell tumors suspected on the basis of severe clinical features of
hyperandrogenism rapidly worsening, with elevated serum total
testosterone levels, in which bilateral ovariectomy was performed and
tumor was confirmed by post-operative histology. In all three cases,
imaging was negative for ovarian tumor. Moreover, in one case the
confounding concomitant finding of bilateral adrenal masses posed an
additional challenge. Our experience highlights that testosterone levels
represent the most helpful marker in the diagnosis of
androgen-secreting ovarian tumor. In the absence of imaging findings,
bilateral ovariectomy should be indicated, if supported by unequivocal
clinical and laboratory data.
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