Postmenopausal hyperandrogenism caused by a benign cystic teratoma: a case report.
BACKGROUND
Mature, benign cystic teratomas of the ovary are common in reproductive-age women, but they are very rarely associated with androgen production and subsequent development of hirsutism or virilization. We describe a case of postmenopausal hirsutism and hyperandrogenism caused by a mature cystic teratoma as well as the 7 previously reported cases.


METHODS
A 55-year-old, postmenopausal woman presented with hirsutism and unilateral lower extremity edema. Pelvic ultrasound showed a complex cystic mass in the left ovary measuring 6.0 x 7.0 x 10 cm, and laboratory evaluations revealed progressively increasing testosterone levels. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, with resection of a large, complex mass originating in the left ovary. The pathology department found 2 left, mature ovarian cystic teratomas containing a layer of Leydig cells. Postoperatively the patient experienced rapid normalization of the elevated testosterone level.


CONCLUSIONS
Although rare, ovarian production of androgens resulting in hirsutism or virilization can occur with a hormonally active mature cystic teratoma.
Wu
Diana H
DH
Department of Obstetrics and Gynecology, Saint Joseph Mercy Hospital, Ann Arbor, Michigan, USA. wudh@trinity-health.org
McMurtrie
Daniel G
DG
Hirsch
Samuel D
SD
Johnston
Carolyn M
CM
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000473:pathology*; D017698:Postmenopause; D013724:Teratoma / Q000150:complications / Q000473:pathology*