title: Bilateral Leydig cell tumour of the ovary: a rare cause of virilization in postmenopausal patient.
abstract: BACKGROUND
  Leydig cell tumours of the ovary are very rare benign neoplasms, frequently associated with symptoms of virilisation, in postmenopausal patients. Only four cases of bilateral Leydig tumours have been reported in the literature.
  
  
  METHODS
  We report an additional case of bilateral presentation. A 77-year-old postmenopausal patient was referred from the Endocrinology Service due to a biochemical diagnosis of hyperandrogenism during hospital admission with unbalanced diabetes mellitus. The patient had suffered from alopecia and hirsutism for many years. Biological data confirmed an increment of androgen production. Ultrasonography showed a well-defined hyperechoic lesion of 12 mm in the right ovary. A CT scan demonstrated adrenal glands and ovaries without tumour. Bilateral adnexectomy by laparoscopy was carried out.
  
  
  RESULTS
  The pathological finding was a bilateral Leydig cell tumour, measuring 15 mm in the right ovary and 3 mm in the left ovary. Following treatment the patient experienced regression of the hirsutism and the plasma testosterone dropped to a normal level.
  
  
  CONCLUSIONS
  In spite of its low incidence, it is a possibility that must be considered in all postmenopausal women with hyperandrogenism, and bilateral adnexectomy by laparoscopy is recommended as a diagnostic test and definitive treatment.
authors.affiliation: Servicio de Ginecología del Hospital, Virgen del Camino de Pamplona, Navarra, Spain. olgasanzasin@hotmail.com
authors.forename: Olga Asín
authors.initials: OA
authors.lastname: Sanz
authors.forename: Pilar Rubio
authors.initials: PR
authors.lastname: Martinez
authors.forename: Rosa Troyas
authors.initials: RT
authors.lastname: Guarch
authors.forename: María José Iriarte
authors.initials: MJ
authors.lastname: Goñi
authors.forename: Juan Luis Zambrano
authors.initials: JL
authors.lastname: Alcazar
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007984:Leydig Cell Tumor / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D017698:Postmenopause; D014463:Ultrasonography; D014770:Virilism / Q000209:etiology*