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      Tumor de células de Leydig puro de ovario en mujer premenopáusica Translated title: Pure Leydig cell tumor of the ovary in a premenopausal woman

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          Abstract

          RESUMEN Los tumores de células de Leydig del ovario son un tipo raro de tumores del estroma del cordón sexual, con menos de 0,1% de todos los tumores de ovario. Representan un desafío diagnóstico, no solo por su incidencia esporádica sino también por presentar imágenes aparentemente normales. Aunque son más comunes en las mujeres menopaúsicas, también se ha descrito casos en mujeres premenopáusicas. La característica clínica más común es la aparición de virilización rápida y progresiva; más de 75% de las pacientes muestra signos de virilización debido a la sobreproducción de testosterona. La concentración sérica de testosterona representa el marcador más útil en el diagnóstico del tumor ovárico secretor de andrógenos. El tumor de células de Leydig ovárico siempre debe ser considerado en mujer en edad reproductiva con síntomas de virilización. Se presenta un caso de tumor de células de Leydig puro de ovario en mujer premenopáusica.

          Translated abstract

          ABSTRACT Leydig cell tumors of the ovary are a rare type of sex cord-stromal tumors, corresponding to less than 0.1% of all ovarian neoplasms. With a low incidence and frequent false-negative imaging results, these tumors represent a diagnostic challenge. Although more common in menopause, cases have also been described in premenopausal women. The most common clinical feature is rapidly progressive virilization; over 75% of patients show signs of virilization due to testosterone overproduction. Serum testosterone concentration is the most useful marker for diagnosing androgen-secreting tumors of the ovary. Leydig cell tumors should always be considered in women of reproductive age with virilization symptoms. We present the case of a pure Leydig cell tumor of the ovary in a premenopausal woman.

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          Most cited references15

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          Sex cord-stromal tumors of the ovary: a comprehensive review and update for radiologists.

          Ovarian sex cord-stromal tumors are infrequent and represent approximately 7% of all primary ovarian tumors. This histopathologic ovarian tumor group differs considerably from the more prevalent epithelial ovarian tumors. Although sex cord-stromal tumors present in a broad age group, the majority tend to present as a low-grade disease that usually follows a nonaggressive clinical course in younger patients. Furthermore, because the constituent cells of these tumors are engaged in ovarian steroid hormone production (e.g., androgens, estrogens, and corticoids), sex cord-stromal tumors are commonly associated with various hormone-mediated syndromes and exhibit a wide spectrum of clinical features ranging from hyperandrogenic virilizing states to hyperestrogenic manifestations. The World Health Organization sex cord-stromal tumor classification has recently been revised, and currently these tumors have been regrouped into the following clinicopathologic entities: pure stromal tumors, pure sex cord tumors, and mixed sex cord-stromal tumors. Moreover, some entities considered in the former classification (e.g., stromal luteoma, stromal tumor with minor sex cord elements, and gynandroblastoma) are no longer considered separate tumors in the current classification. Herein, we discuss and revise the ultrasonography, computed tomography, and magnetic resonance imaging characteristics of the different histopathologic types and clinicopathologic features of sex cord-stromal tumors to allow radiologists to narrow the differential diagnosis when facing ovarian tumors.
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            Hyperandrogenism after menopause.

            Postmenopausal hyperandrogenism is a state of relative or absolute androgen excess originating from either the adrenals and/or the ovaries, clinically manifested as the appearance and/or increase in terminal hair growth or the development of symptoms/signs of virilization. In either settings, physicians need to evaluate such patients and exclude the presence of the relatively rare but potentially life-threatening underlying tumorous causes, particularly adrenal androgen-secreting tumors. It has been suggested that the rapidity of onset along with severity of symptom and the degree of androgen excess followed by relevant imaging studies may suffice to identify the source of excessive androgen secretion. However, up to date, there is no consensus regarding specific clinical and hormonal indices and/or imaging modalities required for diagnostic certainty. This is particularly relevant as the aging population is increasing and more cases of postmenopausal women with clinical/biochemical evidence of hyperandrogenism may become apparent. Furthermore, the long-term sequels of nontumorous hyperandrogenism in postmenopausal women in respect to cardiovascular morbidity and mortality still remain unsettled. This review delineates the etiology and pathophysiology of relative and absolute androgen excess in postmenopausal women. Also, it attempts to unravel distinctive clinical features along with specific hormonal cut-off levels and/or appropriate imaging modalities for the facilitation of the differential diagnosis and the identification of potential long-term sequels.
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              Ovarian sex cord-stromal tumours: an update in recent molecular advances

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                Author and article information

                Journal
                rgo
                Revista Peruana de Ginecología y Obstetricia
                Rev. peru. ginecol. obstet.
                Sociedad Peruana de Obstetricia y Ginecología (Lima, , Peru )
                2304-5132
                April 2020
                : 66
                : 2
                : 00014
                Affiliations
                [1] Madrid orgnameHospital Universitario Príncipe de Asturias España
                [2] Maracaibo Estado Zulia orgnameHospital Central "Dr. Urquinaona" Venezuela
                Article
                S2304-51322020000200014 S2304-5132(20)06600200014
                10.31403/rpgo.v66i2257
                633aaca1-2663-4eb5-95af-cc4b797092e2

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 09 October 2019
                : 15 August 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 0
                Product

                SciELO Peru

                Categories
                Caso Clínico

                Ovarian neoplasms,Virilismo,Neoplasias de ovario,Tumor de células de Leydig,Virilization,Leydig cell tumor

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