Hyperandrogenism due to ovarian Leydig cell tumour presenting with polycythaemia

A postmenopausal woman in her 60s was referred due to an elevated haemoglobin value found during her annual check-up. On physical examination, characteristic features of hyperandrogenism were observed which were not earlier mentioned. Laboratory investigations revealed polycythaemia accompanied by a...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2022-07, Vol.15 (7), p.e249651
Main Authors: Demir, Ayşe Y, Blok, Bas B, Brinkhuis, Egbert A, Oldenburg-Ligtenberg, Christine P
Format: Article
Language:English
Subjects:
Abdomen
Adrenal glands
Alopecia
Anabolic steroids
Androgens
Baldness
Case reports
Case Reports: Unusual presentation of more common disease/injury
Cysts
Female
Hematology
Hemoglobin
Humans
Hyperandrogenism - diagnosis
Hypoxia
Laboratories
Leydig Cell Tumor - complications
Leydig Cell Tumor - diagnosis
Leydig Cell Tumor - surgery
Male
Mutation
Oophorectomy
Ovarian Neoplasms - complications
Ovarian Neoplasms - diagnosis
Ovarian Neoplasms - surgery
Ovaries
Polycythemia - complications
Surgery
Testosterone
Tumors
Ultrasonic imaging
Womens health
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A postmenopausal woman in her 60s was referred due to an elevated haemoglobin value found during her annual check-up. On physical examination, characteristic features of hyperandrogenism were observed which were not earlier mentioned. Laboratory investigations revealed polycythaemia accompanied by a normal erythropoietin and a negative analysis for JAK2-V617F mutation. A disproportionally and markedly elevated testosterone in combination with normal levels of adrenal androgens raised the suspicion of an ovarian source. CT scan showed nodular hyperdense lesions in both ovaries. A bilateral oophorectomy was performed and histological evaluation unfolded a Leydig cell ovarian tumour. Testosterone levels and haematological parameters normalised after surgery. Polycythaemia secondary to hyperandrogenism in postmenopausal women is an extremely rare condition and patients should be carefully analysed for the presence of androgen-secreting neoplasms. Diagnosis of the underlying pathology requires careful history, physical examination and comprehensive investigation. Treatment for this condition is surgery and resolves polycythaemia.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2022-249651