Virilizing ovarian Leydig cell tumor in a woman with subclinical cushing syndrome

Dima L. Diab, Charles Faiman, Allan E. Siperstein, William F. Grossman, Laura O. Rabinowitz, Amir Hamrahian

Research output: Contribution to journalArticle

Abstract

Objective: To report the case of a patient with a virilizing ovarian Leydig cell tumor and subclinical Cushing syndrome attributable to an adrenal adenoma. Methods: Detailed clinical, laboratory, radiologic, and pathologic findings are presented, and the pertinent literature is reviewed. Results: A 49-year-old woman was referred for evaluation of a left adrenal mass (3.0 by 2.4 cm), which had been diagnosed by computed tomographic scan 4 years previously during a work-up for hirsutism. On examination, she had central obesity, facial hirsutism, and male pattern baldness. Work-up showed elevated total and free testosterone levels of 196 ng/dL (reference range, 20 to 70) and 24 pg/mL (1 to 9), respectively. Other results (and reference ranges) were as follows: dehydroepiandrosterone sulfate, 7.5 μg/dL (10 to 221); corticotropin, 12 pg/mL (5 to 50); morning cortisol, 1.4 μg/dL after a 1-mg overnight dexamethasone suppression test; and urine free cortisol, 48.8 μg/24 h (20 to 100). The testosterone level decreased by 14% after a 2-day low-dose dexamethasone suppression test. Findings on transvaginal ovarian ultrasonography and a computed tomographic scan of the pelvis were normal. A laparoscopic adrenalectomy revealed an adrenal adenoma. On the first day postoperatively, the cortisol level was less than 1.0 μg/dL; however, the testosterone level remained elevated. At 6 months postoperatively, a normal result of a cosyntropin stimulation test indicated recovery of the hypothalamic-pituitaryadrenal axis. Bilateral oophorectomy revealed a 1.3-cm right ovarian Leydig cell tumor. Postoperatively, the testosterone level declined to less than 20 ng/dL. Conclusion: To our knowledge, this is the first case report of a virilizing ovarian Leydig cell tumor in a patient with subclinical Cushing syndrome.

Original languageEnglish (US)
Pages (from-to)358-361
Number of pages4
JournalEndocrine Practice
Volume14
Issue number3
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

Fingerprint

Leydig Cell Tumor
Cushing Syndrome
Testosterone
Hydrocortisone
Hirsutism
Adenoma
Dexamethasone
Reference Values
Cosyntropin
Dehydroepiandrosterone Sulfate
Abdominal Obesity
Adrenalectomy
Alopecia
Ovariectomy
Pelvis
Adrenocorticotropic Hormone
Ultrasonography
Urine

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Diab, D. L., Faiman, C., Siperstein, A. E., Grossman, W. F., Rabinowitz, L. O., & Hamrahian, A. (2008). Virilizing ovarian Leydig cell tumor in a woman with subclinical cushing syndrome. Endocrine Practice, 14(3), 358-361. https://doi.org/10.4158/EP.14.3.358

Virilizing ovarian Leydig cell tumor in a woman with subclinical cushing syndrome. / Diab, Dima L.; Faiman, Charles; Siperstein, Allan E.; Grossman, William F.; Rabinowitz, Laura O.; Hamrahian, Amir.

In: Endocrine Practice, Vol. 14, No. 3, 01.01.2008, p. 358-361.

Research output: Contribution to journalArticle

Diab, DL, Faiman, C, Siperstein, AE, Grossman, WF, Rabinowitz, LO & Hamrahian, A 2008, 'Virilizing ovarian Leydig cell tumor in a woman with subclinical cushing syndrome', Endocrine Practice, vol. 14, no. 3, pp. 358-361. https://doi.org/10.4158/EP.14.3.358
Diab, Dima L. ; Faiman, Charles ; Siperstein, Allan E. ; Grossman, William F. ; Rabinowitz, Laura O. ; Hamrahian, Amir. / Virilizing ovarian Leydig cell tumor in a woman with subclinical cushing syndrome. In: Endocrine Practice. 2008 ; Vol. 14, No. 3. pp. 358-361.
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