Low leptin level in an obese hyperandrogenic woman--potential marker for androgen-secreting tumor.
Hyperandrogenism in postmenopausal women is due to ovarian hyperthecosis or an androgen-secreting ovarian/adrenal tumor. Making the correct diagnosis might be complicated due to the possible existence of an adrenal neoplasm secreting testosterone only, ectopic ovarian tissue or ectopic luteinizing hormone/human chorionic gonadotropin receptors in the adrenals, as well as the relatively low sensitivity of imaging techniques (computed tomography, magnetic resonance imaging) and vein catheterization for this type of pathology. We present the case of an obese postmenopausal woman with metabolic syndrome, hyperandrogenism (high testosterone levels, suppressed gonadotropins), adrenal macronodular hyperplasia and Leydig-cell ovarian tumor. At presentation she had low leptin levels despite high body fat content. After a catheter study left adrenalectomy was carried out but hyperandrogenism persisted. Then, bilateral oophorectomy with hysterectomy was performed and a small Leydig-cell tumor was found in the left ovary. Postoperatively, testosterone and gonadotropin levels were normal (postmenopausal) and leptin level became elevated without change in body mass index or body fat content. In conclusion, we speculate that low leptin levels in obese hyperandrogenic women might be a marker for androgen-secreting tumors.
Cvijovic
Goran
G
Institute of Endocrinology, Diabetes and Diseases of Metabolism, Dr Subotica 13, 11000 Belgrade, Serbia.
Yamashita
Sylvia A Y
SA
Micic
Dragan
D
Kendereski
Aleksandra
A
Sumarac-Dumanovic
Mirjana
M
Zoric
Svetlana
S
Popovic
Vera
V
D000311:Adrenal Glands / Q000473:pathology; D000505:Alopecia / Q000209:etiology*; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D005260:Female; D006628:Hirsutism / Q000209:etiology*; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D006965:Hyperplasia / Q000150:complications; D020738:Leptin / Q000097:blood / Q000378:metabolism; D007984:Leydig Cell Tumor / Q000150:complications / Q000378:metabolism*; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009765:Obesity; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*
D015415:Biomarkers; D020738:Leptin