title: Maternal luteoma of pregnancy presenting with virilization of the female infant.
abstract: BACKGROUND
  Virilization in female newborns typically results from congenital adrenal hyperplasia, requiring immediate diagnosis and treatment. We report a rare cause of virilization, maternal pregnancy luteoma, responsible for virilization of both a newborn and the mother. Luteomas are usually asymptomatic tumour-like ovarian lesions of pregnancy that secrete androgens in only 25% of cases. Many female infants born to masculinized mothers will also be virilized.
  
  
  METHODS
  A term infant born with ambiguous genitalia was transferred to a referral centre for investigation, diagnosis, and treatment. Assessment identified Prader II-III genitalia, an elevated serum testosterone level, a normal serum 17-hydroxyprogesterone level, and a normal female karyotype (46,XX). The mother had had virilization from the second trimester and was found to have an elevated serum testosterone level. Pelvic ultrasound assessment in the mother showed a complex right ovarian mass. Laparotomy was performed, and the mass was excised. Histopathology examination confirmed a luteoma.
  
  
  CONCLUSIONS
  High maternal serum testosterone levels due to a luteoma can result in virilization in the female newborn. This report emphasizes the need to consider possible underlying maternal pathology in evaluating a virilized female infant.
authors.affiliation: Section of Gynecology, Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Toronto ON.
authors.forename: Rachel F
authors.initials: RF
authors.lastname: Spitzer
authors.forename: Diane
authors.initials: D
authors.lastname: Wherrett
authors.forename: David
authors.initials: D
authors.lastname: Chitayat
authors.forename: Terence
authors.initials: T
authors.lastname: Colgan
authors.forename: Jason Esli
authors.initials: JE
authors.lastname: Dodge
authors.forename: Joao Luiz Pippi
authors.initials: JL
authors.lastname: Salle
authors.forename: Lisa
authors.initials: L
authors.lastname: Allen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018311:Luteoma / Q000097:blood / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis*; D013739:Testosterone / Q000097:blood*; D014770:Virilism / Q000097:blood*
chemical_list: D013739:Testosterone