A Virilizing Ovarian Tumor in a Postmenopausal Woman

卵巢腫瘤引起停經婦女產生多毛症或雄性化的現象相當罕見，因此特別提出來報告。這是一個70歲停經婦女，主訴漸進性額頂禿髮及面部鬍鬚增生約5個月之久。過去病史方面，6年前發現糖尿病，以口服降血糖藥及飲食控制。月經及生產史正常，無雄性化或多毛症家族史。理學檢查除禿髮和面部多毛外，無異常發現。經陰道超音波檢查，發現在側卵巢較大（24×26×29mm），併一2公分大小的結節。腹腔鏡檢因骨盆沾黏而視野不佳。腎上腺斷層掃描正常。血漿睪固酮高（12.1ng/ml）而DHEA-S （dehydroepiandrosterone sulfate，androstenedion及17-OHp（17-hydroxyprogesterone）均正常。因為腎上腺斷層掃描，血漿DHEA-S和dexamethasone抑制試驗正常再加上陰道超音波的發現，所以認為過高的雄性素來自卵巢。剖腹切除子宮及卵巢，經病理檢查證實為左側卵巢萊狄氏細胞瘤。手術後血漿睪固酮即降至正常值（0.1ng/ml），而病人狀況良好於術後2週出院。

關鍵字

雄性化卵巢瘤；停經後婦女；雄性化；萊狄氏細胞瘤

並列摘要

Androgen-producing ovarian tumors are a relatively uncommon but serious cause of virilization in postmenopausal women. We present the case of a 70-year-old woman referred for evaluation of virilization which developed over 5 months. Clinical examinations and investigations suggested that the source of androgen excess was ovarian origin. An ovarian tumor was confirmed (Leydig cell tumor) and removed at laparotomy. The serum androgen level returned to normal soon postoperatively. It is emphasized here that evidence of virilization is a key feature that requires investigation.

並列關鍵字

virilizing tumor ； postmenopausal woman ； virilization ； Leydig cell tumor

國際替代計量

A Virilizing Ovarian Tumor in a Postmenopausal Woman

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