title: Ovarian intratumoral 21-hydroxylase deficiency in a postmenopausal hirsute woman.
abstract: Virilising ovarian tumours are a rare cause of hyperandrogenism in women, accounting for less than 5% of all ovarian neoplasms. It occurs most often in - and postmenopausal women. We report a case of a 64 year-old woman with signs of virilisation that had started 3 years before. Blood hormone analysis revealed increased levels of testosterone, and 17-hydroxyprogesterone. The tetracosactin test revealed 21-hydroxylase deficiency. Radiological imaging demonstrated a nodule in her left ovary. The patient was submitted to bilateral laparoscopic oophorectomy, and histopathological examination revealed a luteoma of the left ovary. Postoperative serum testosterone level and 17-hydroxyprogesterone returned to normal levels in one month. Virilism regressed within six months. Our patient also showed an elevation in 17-OHP serum levels. Normalization of 17-OHP after oophorectomy suggests a case of intratumoral 21-hydroxylase deficiency. To our knowledge, this is the first description of ovarian intratumoral 21-hydroxylase deficiency in a postmenopausal woman.
authors: School of Medicine, University of Porto, Porto, Portugal. sbsouto.md@mail.com
authors: Selma B
authors: SB
authors: Souto
authors: Pedro V
authors: PV
authors: Baptista
authors: Filomena
authors: F
authors: Barreto
authors: Pedro F
authors: PF
authors: Sousa
authors: Daniel C
authors: DC
authors: Braga
authors: Davide
authors: D
authors: Carvalho
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000473:pathology*; D003366:Cosyntropin; D005260:Female; D006628:Hirsutism / Q000209:etiology* / Q000473:pathology; D006801:Humans; D018311:Luteoma / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications* / Q000473:pathology; D017698:Postmenopause; D013739:Testosterone / Q000097:blood
chemical_list: D003366:Cosyntropin; D013739:Testosterone