Hyperandrogenism in a postmenopausal woman presenting with a metastatic ileum endocrine tumor.
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.
Bachelot
Anne
A
Department of Endocrinology and Reproductive Medicine, Hôpital Necker, Paris, France.
Meduri
Geri
G
Baudin
Eric
E
Kuttenn
Frédérique
F
Touraine
Philippe
P
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
D018997:Chorionic Gonadotropin, beta Subunit, Human; D013254:Steroid 17-alpha-Hydroxylase; D002786:Cholesterol Side-Chain Cleavage Enzyme