title: Virilizing leydig-sertoli cell ovarian tumor associated with endometrioid carcinoma of the endometrium in a postmenopausal patient: case report and general considerations.
abstract: BACKGROUND
  Sertoli-Leydig cell tumors (SLCTs) are rare tumors mostly occurring in young women. Here we report an unusual case of a SLCT with simultaneous occurrence of endometrioid adenocarcinoma of the endometrium in a woman in menopause.
  
  
  METHODS
  A 67-year-old woman presented with progressive signs of virilization. Blood tests showed increased levels of testosterone, delta-4-androstenedione, and dehydroepiandrosterone (DHEA). DHEA-sulphate, 17β-estradiol, estrone, and sex-hormone binding globulin serum levels were within the normal range. Magnetic resonance imaging revealed a solid mass of 2.7 × 2.9 cm in the right ovary set against the background of the uterus. The patient underwent bilateral salpingo-oophoretomy with hysterectomy. The mass in the right ovary was a differentiated SLCT. Incidentally, the endometrium revealed an endometrioid adenocacinoma. Following surgical treatment the plasma androgens dropped to normal levels, and signs and symptoms of virilization improved.
  
  
  CONCLUSIONS
  SLCT should be suspected in postmenopausal women who present rapid progressive androgen excess symptoms with hyperandrogenemia.
authors.affiliation: Division of Endocrinology, Department of System Medicine, Section of Reproductive Endocrinology University of TorVergata, Fatebenefratelli Hospital (San Giovanni Calibita), Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Di Giacinto
authors.forename: Laura
authors.initials: L
authors.lastname: Chioma
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vancieri
authors.forename: Laura
authors.initials: L
authors.lastname: Guccione
authors.forename: Elena
authors.initials: E
authors.lastname: Cicerone
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ulisse
authors.forename: Stefania
authors.initials: S
authors.lastname: Mariani
authors.forename: Camillo
authors.initials: C
authors.lastname: Autore
authors.forename: Andrea
authors.initials: A
authors.lastname: Fabbri
authors.forename: Lucio
authors.initials: L
authors.lastname: Gnessi
authors.forename: Costanzo
authors.initials: C
authors.lastname: Moretti
keywords: Sertoli-Leydig tumor; endometrial cancer; hyperandrogenism; ovarian cancer; virilization