title: Hyperandrogenism in a postmenopausal woman presenting with a metastatic ileum endocrine tumor.
abstract: OBJECTIVE
  To elucidate the mechanism of the hyperandrogenism found in a postmenopausal woman presenting an ileum endocrine tumor with ovarian metastases.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A postmenopausal woman was referred for hirsutism. Basal plasma testosterone was high, 6.6 nM/L (normal, <or=0.7 nM/L). Pelvic magnetic resonance imaging revealed a 6-cm left ovarian mass.
  
  
  METHODS
  Bilateral salpingo-oophorectomy was performed. Pathological examination found a bilateral metastatic endocrine ovarian tumor, associated with a functional stroma. A primary ileum endocrine tumor was discovered and resected.
  
  
  METHODS
  Immunohistochemical study of the expression of steroidogenic enzymes and beta and alpha subunits of hCG.
  
  
  RESULTS
  Immunohistochemical expression of steroidogenic enzymes was found in the ovarian stromal tissue surrounding the tumor but not in the metastatic tumoral cells. A substantial percentage of the metastatic tumoral cells was immunopositive for the beta and alpha subunit of hCG but not the ileal cells.
  
  
  CONCLUSIONS
  These data suggest an hCG paracrine effect of the ovarian metastases tumor on the adjacent interstitial cells, resulting in the virilization of the patient.
authors.affiliation: Department of Endocrinology and Reproductive Medicine, Hôpital Necker, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Bachelot
authors.forename: Geri
authors.initials: G
authors.lastname: Meduri
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.forename: Frédérique
authors.initials: F
authors.lastname: Kuttenn
authors.forename: Philippe
authors.initials: P
authors.lastname: Touraine
mesh_terms: D002786:Cholesterol Side-Chain Cleavage Enzyme / Q000378:metabolism; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000378:metabolism; D004701:Endocrine Gland Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000556:secondary; D005260:Female; D006628:Hirsutism / Q000209:etiology*; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D007078:Ileal Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000556:secondary; D007150:Immunohistochemistry; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology; D017698:Postmenopause; D013254:Steroid 17-alpha-Hydroxylase / Q000378:metabolism
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D013254:Steroid 17-alpha-Hydroxylase; D002786:Cholesterol Side-Chain Cleavage Enzyme