Ovarian hyperthecosis coexisting with an incidental adrenal lesion: challenges in the diagnostic approach
Ovarian hyperthecosis is the most common cause of hyperandrogenism in women during postmenopausal age. However, its diagnosis is frequently challenging, since several causes must be ruled out, involving both adrenal glands and ovaries. Herein we describe the case of a 62 years old woman addressed to...
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Accademia Peloritana dei Pericolanti
2017-06-01
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| Series: | Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche |
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| Online Access: | http://cab.unime.it/journals/index.php/APMB/article/view/1541 |
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| author | Giuseppe Giuffrida Salvatore Giovinazzo Rosaria Certo Francesco Trimarchi Salvatore Cannavò Rosaria M Ruggeri |
| author_facet | Giuseppe Giuffrida Salvatore Giovinazzo Rosaria Certo Francesco Trimarchi Salvatore Cannavò Rosaria M Ruggeri |
| author_sort | Giuseppe Giuffrida |
| collection | DOAJ |
| description | Ovarian hyperthecosis is the most common cause of hyperandrogenism in women during postmenopausal age. However, its diagnosis is frequently challenging, since several causes must be ruled out, involving both adrenal glands and ovaries. Herein we describe the case of a 62 years old woman addressed to our Unit after the casual detection of an adrenal mass, compatible with an adenoma. Biochemical evaluation revealed gonadotropins in menopausal range, high testosterone and androstenedione, while the patient had been complaining of androgenetic alopecia and hirsutism for some years. Ultrasound imaging revealed only a small increase in ovarian volume, in relationship to the patient’s age. A GnRHa test was performed, demonstrating gonadotropins suppression and testosterone normalization, thus confirming the suspect of ovarian hyperthecosis. The administration of these agonists, together with the slow progression of symptoms over years, play a fundamental role into excluding an androgen-secreting neoplasia, also limiting the use of ovarian veins catheterization as second line test. Besides, they represent a valid therapeutical option, especially when surgery is contraindicated (or cannot be performed). |
| first_indexed | 2024-12-22T21:22:10Z |
| format | Article |
| id | doaj.art-90a0c9c5637f4d0eb4ce0f169f29f934 |
| institution | Directory Open Access Journal |
| issn | 0365-0294 1828-6550 |
| language | English |
| last_indexed | 2024-12-22T21:22:10Z |
| publishDate | 2017-06-01 |
| publisher | Accademia Peloritana dei Pericolanti |
| record_format | Article |
| series | Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche |
| spelling | doaj.art-90a0c9c5637f4d0eb4ce0f169f29f9342022-12-21T18:12:10ZengAccademia Peloritana dei PericolantiAtti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche0365-02941828-65502017-06-01105110.6092/1828-6550/APMB.105.1.2017.A11233Ovarian hyperthecosis coexisting with an incidental adrenal lesion: challenges in the diagnostic approachGiuseppe Giuffrida0Salvatore Giovinazzo1Rosaria Certo2Francesco Trimarchi3Salvatore Cannavò4Rosaria M Ruggeri5Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of MessinaUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of MessinaUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of MessinaAccademia Peloritana dei Pericolanti, Messina<p>Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina</p> <p>Accademia Peloritana dei Pericolanti, Messina</p><p>Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina</p> <p>Accademia Peloritana dei Pericolanti, Messina</p>Ovarian hyperthecosis is the most common cause of hyperandrogenism in women during postmenopausal age. However, its diagnosis is frequently challenging, since several causes must be ruled out, involving both adrenal glands and ovaries. Herein we describe the case of a 62 years old woman addressed to our Unit after the casual detection of an adrenal mass, compatible with an adenoma. Biochemical evaluation revealed gonadotropins in menopausal range, high testosterone and androstenedione, while the patient had been complaining of androgenetic alopecia and hirsutism for some years. Ultrasound imaging revealed only a small increase in ovarian volume, in relationship to the patient’s age. A GnRHa test was performed, demonstrating gonadotropins suppression and testosterone normalization, thus confirming the suspect of ovarian hyperthecosis. The administration of these agonists, together with the slow progression of symptoms over years, play a fundamental role into excluding an androgen-secreting neoplasia, also limiting the use of ovarian veins catheterization as second line test. Besides, they represent a valid therapeutical option, especially when surgery is contraindicated (or cannot be performed).http://cab.unime.it/journals/index.php/APMB/article/view/1541HyperandrogenismHirsutismPostmenopausal Age |
| spellingShingle | Giuseppe Giuffrida Salvatore Giovinazzo Rosaria Certo Francesco Trimarchi Salvatore Cannavò Rosaria M Ruggeri Ovarian hyperthecosis coexisting with an incidental adrenal lesion: challenges in the diagnostic approach Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche Hyperandrogenism Hirsutism Postmenopausal Age |
| title | Ovarian hyperthecosis coexisting with an incidental adrenal lesion: challenges in the diagnostic approach |
| title_full | Ovarian hyperthecosis coexisting with an incidental adrenal lesion: challenges in the diagnostic approach |
| title_fullStr | Ovarian hyperthecosis coexisting with an incidental adrenal lesion: challenges in the diagnostic approach |
| title_full_unstemmed | Ovarian hyperthecosis coexisting with an incidental adrenal lesion: challenges in the diagnostic approach |
| title_short | Ovarian hyperthecosis coexisting with an incidental adrenal lesion: challenges in the diagnostic approach |
| title_sort | ovarian hyperthecosis coexisting with an incidental adrenal lesion challenges in the diagnostic approach |
| topic | Hyperandrogenism Hirsutism Postmenopausal Age |
| url | http://cab.unime.it/journals/index.php/APMB/article/view/1541 |
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