A renin secreting ovarian steroid cell tumour associated with secondary polycythaemia.
A 67-year-old woman presented with dry skin, facial hair, hoarse voice, and weight gain. She was hypertensive (168/ 96 mm Hg), her haemoglobin concentration was 19 g/l, and haematocrit was 55.7%. The diagnosis of probable secondary polycythaemia was made. Blood testosterone concentration was 44 nmol/l (normal < 5) and was not suppressed by dexamethasone, suggesting a neoplastic source rather than a pituitary abnormality. Transvaginal ultrasound revealed a hypoechoic solid mass in the left ovary suggestive of a solid ovarian tumour. Hysterectomy and bilateral salpingo-oophorectomy were performed following which testosterone concentration returned to normal. Immunocytochemistry provided evidence of renin synthesis. This is a case of an unusual steroid cell tumour that caused virilisation accompanied by symptoms of secondary polycythaemia presumably as a result of erythropoietin production. This is the second case of a steroid cell tumour with an erythropoietic effect and the first that shows evidence of renin synthesis.
Stephen
M R
MR
University Department of Pathology, Western Infirmary, Glasgow, UK.
Lindop
G B
GB
D000368:Aged; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D011086:Polycythemia / Q000209:etiology*; D012083:Renin / Q000378:metabolism*; D014770:Virilism / Q000209:etiology
D012083:Renin