Hyperandrogenism due to a testosterone-secreting Ovarian Leydig cell tumor

Leydig cell tumors of the ovary are rare benign neoplasms, frequently associated with symptoms of virilization, in postmenopausal patients. They belong to the group of androgen-secreting tumors, which account for less than 0.5% of all ovarian tumors. We present the case of a 75-year-old woman with a two years history of gradual alopecia and deepening of voice. Laboratory tests showed elevated levels of free testosterone and a transvaginal ultrasonography disclosed a solid left ovarian tumor. An ovarian source of androgens was suspected and a bilateral laparoscopic adnexectomy was performed. Histological results revealed a left ovarian Leydig cell tumor. After surgery, the patient showed significant regression of clinical signs and symptoms. Androgen-secreting ovarian tumors represent a diagnostic and therapeutic challenge. Although rare, it is important to remember that they have to be considered in the differential diagnosis of severe hyperandrogenism. (C) 2014 Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Published by Elsevier Espafia, S.L.U. All rights reserved.