Maternal luteoma of pregnancy presenting with virilization of the female infant.
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.
Spitzer
Rachel F
RF
Section of Gynecology, Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Toronto ON.
Wherrett
Diane
D
Chitayat
David
D
Colgan
Terence
T
Dodge
Jason Esli
JE
Salle
Joao Luiz Pippi
JL
Allen
Lisa
L
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*
D013739:Testosterone