Amenorrhoea and failure to virilize in a patient with a testosterone secreting granulosa cell tumour.

Abstract:

:A 39-year-old woman presented with secondary amenorrhoea in the absence of galactorrhoea, hirsutism or virilization. Investigation revealed a strikingly elevated serum testosterone, dihydrotesterone, free testosterone and LH level. At laparotomy a large granulosa cell tumour was encountered and totally removed. Analysis of the tumour revealed 127 ng of testosterone/mg of tumour tissue. The testosterone was localized immunocytochemically to the granulosa cells, which demonstrated typical ultrastructural characteristics of oestrogen rather than androgen secreting tissue. A study of androgen binding and metabolism prior to tumour resection revealed a normal androgen receptor as evidenced by normal maximum binding, dissociation constant and nuclear uptake. Removal of the tumour resulted in a return to normal of all abnormalities. We conclude that granulosa cell tumours may rarely secret large amounts of testosterone and that in this situation their ultrastructure is unchanged. Furthermore, absence of LH suppression or hirsutism in an amenorrhoeic patient does not dismiss the possibility of a significant androgen-secreting tumour. In this situation, the failure to virilize may be due to a post-nuclear translocational defect.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Taylor HC,Velasco ME,Flores SG,Berg G,Brown TR

doi

10.1111/j.1365-2265.1982.tb01628.x

subject

Has Abstract

pub_date

1982-12-01 00:00:00

pages

557-67

issue

6

eissn

0300-0664

issn

1365-2265

journal_volume

17

pub_type

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