title: Virilising Sertoli-Leydig cell tumour associated with thyroid papillary carcinoma: case report and general considerations.
abstract: We present a case of a Sertoli-Leydig cell tumour manifested with progressive hirsutism, frontal alopecia and secondary amenorrhea in a 46-years-old female, evolving for 6 years until presentation. Serum testosterone level was 8.01 ng/ml and gonadotropic hormones were LH 8.57 mIU/ml and FSH 9.52 mIU/ml. Computed tomography revealed a dense, solid, heterogeneous mass of 3.5/2.8 cm in the right ovary. Bilateral ovariectomy and hysterectomy were performed. The histopathological report mentioned a Sertoli-Leydig cell tumor with intermediate grade of differentiation. Immunohistochemical stains showed positive reaction for alpha-inhibin, calretin and for progesterone receptor. The testosterone levels dramatically decreased after surgery (0.31 ng/ml) while levels of gonadotropes increased: LH 40.98 mIU/ml and FSH 50.41 mIU/ml. At 6 months follow-up the diagnosis of a left lobe thyroid nodule leaded to fine needle aspiration biopsy with suspicion of papillary carcinoma. Total thyroidectomy established the diagnosis of thyroid papillary carcinoma (2.17/2.18 cm) T2N0M0, stage II, followed by radioiodine administration. This is to our knowledge the first presented case of ovarian Sertoli-Leydig cell tumour associated with papillary thyroid carcinoma. This could suggest a common genetic background.
authors.affiliation: Department of Endocrinology, C I Parhon Institute of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. endoparhon@gmail.com
authors.forename: Catalina
authors.initials: C
authors.lastname: Poiana
authors.forename: Ioana
authors.initials: I
authors.lastname: Virtej
authors.forename: Mara
authors.initials: M
authors.lastname: Carsote
authors.forename: Gabriel
authors.initials: G
authors.lastname: Banceanu
authors.forename: Maria
authors.initials: M
authors.lastname: Sajin
authors.forename: Bogdan
authors.initials: B
authors.lastname: Stanescu
authors.forename: Dumitru
authors.initials: D
authors.lastname: Ioachim
authors.forename: Dan
authors.initials: D
authors.lastname: Hortopan
authors.forename: Mihail
authors.initials: M
authors.lastname: Coculescu
mesh_terms: D000505:Alopecia / Q000209:etiology; D000568:Amenorrhea / Q000209:etiology; D002291:Carcinoma, Papillary / Q000150:complications*; D005260:Female; D006628:Hirsutism / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D010051:Ovarian Neoplasms / Q000150:complications*; D018310:Sertoli-Leydig Cell Tumor / Q000150:complications*; D013964:Thyroid Neoplasms / Q000150:complications*