Search
ovarian hyperthecosis
Epidemiology:
- rare
Pathology:
- abnormal regulation of ovarian steroidogenesis
- hyperandrogenism
- bilateral ovarian enlargement
- with stromal hyperthecosis, assess endometrium for hyperplasia & carcinoma
Clinical manifestations:
- hirsutism
- alopecia
- deepening of voice
Laboratory:
- serum testosterone elevated
- serum free testosterone elevated
- serum DHEA may be normal
- serum FSH normal
- serum LH normal
- serum estradiol normal
- serum prolactin normal
- serum cortisol normal
- serum TSH normal
- serum glucose
- HgbA1c
Radiology:
- transvaginal ultrasonography
Complications:
- severe insulin resistance occurs
- acanthosis nigricans
- diabetes mellitus
Management:
- hysterectomy & bilateral salpingo-oophorectomy (TAH-BSO)
- GnRH agonist for patients who are not surgical candidates
General
ovarian disease
References
- McMahon GT, Bennett JA.
CASE RECORDS of the MASSACHUSETTS GENERAL HOSPITAL.
Case 33-2015. A 57-Year-Old Woman with Hair Loss and Deepening
Voice.
N Engl J Med. 2015 Oct 22;373(17):1660-6.
PMID: 26488697
- Rothaus C
A Woman with a Deepening Voice
Now@NWJM. Oct 23m 2015
http://blogs.nejm.org/now/index.php/a-woman-with-a-deepening-voice/2015/10/23/