VIRILIZING OVARIAN TUMORS IN POSTMENOPAUSE: A LITERATURE REVIEW AND A RARE CLINICAL CASE

Background. Sertoli-Leydig cell ovarian tumors are rare and account for less than 0.5% of all ovarian tumors. Sertoli-Leydig cell tumors can develop in women of any age group; however, they are more common in young female patients with a mean age of 25 years. The distinguishing feature of Sertoli-Leydig cell tumors is their ability to secrete androgens that may cause defeminization. It is rather difficult to diagnose androgen-producing tumors in postmenopause, since the sharp decline in estrogen levels and a slower decrease in androgen levels while maintaining the synthesis throughout life are natural hormonal changes. Case report. The paper analyzes literature data and a rare clinical case of Sertoli-Leydig cell tumor in postmenopausal female patient with breast cancer. The patient was observed to have pronounced signs of virilism: hirsutism, deepening voice, alopecia, and clitoromegaly. MRI revealed a 33-mm left solid ovarian tumor accumulating a contrast agent. She was diagnosed with an increase in blood testosterone levels up to 10 nmol/L (normal value, less than 1.24 nmol/L). The patient underwent surgical treatment: laparoscopy, hysterectomy, bilateral removal of the appendages, and omentectomy. Morphological examination diagnosed a moderate left Sertoli-Leydig cell ovarian tumor. The testosterone level was noted to decrease after surgery. No tumor recurred during one year of follow-up. Conclusion. Thus, postmenopausal patients with pronounced signs of hyperandrogenism should be examined to exclude rare diseases, such as androgen-producing tumors.

Sertoli-Leydig cell tumor, sex cord tumor, postmenopause, defeminization, virilization, androgen- producing tumors, hysterectomy