Abstract
Mild hirsutism and alopecia in postmenopausal women can be a normal physiological response. Sex cord stromal tumors of ovary account for approximately 5-8% of all ovarian tumors. When hirsutism is accompanied by signs of virilization such as severe balding, deepening of voice or clitoromegaly, an underlying androgen-secreting tumor, that may be malignant must be ruled out. We report a rare case of 46 year old female with premature menopause and symptom of hair loss. She had high testosterone levels and left ovary mass. As Cushing syndromes and late onset congenital adrenal hyperplasia were ruled out, an ovarian source of androgen was suspected. She underwent hysterectomy with bilateral salpingo-oophorectomy. A diagnosis of left ovarian sex-cord stromal tumor favoring Sertoli-Leydig cell tumor was confirmed. We report this case for its rare nature and atypical presentation.
Highlights
Mild hirsutism and alopecia in postmenopausal women can be a normal physiological response: with reduction of ovarian follicles, there is diminished secretion of estrogen and progesterone, increasing the impact of androgen on sebaceous glands and hair follicles [1]
We report this case for its rare nature and atypical presentation
Post-menopausal virilization may result from adrenal tumors, including androgen-secreting carcinomas and adenomas; from ovarian tumors, including Sertoli-Leydig cell tumors, granulosa-theca cell tumors and hiluis cell tumors; or from benign ovarian conditions such as ovarian stromal hyperplasia and hyperthecosis [3]
Summary
Mild hirsutism and alopecia in postmenopausal women can be a normal physiological response: with reduction of ovarian follicles, there is diminished secretion of estrogen and progesterone, increasing the impact of androgen on sebaceous glands and hair follicles [1]. The post-menopausal ovary remains hormonally active, secreting sufficient amounts of androgens and estrogens, many years after menopause [2]. When hirsutism is accompanied by signs of virilization such as severe balding, deepening of voice or clitoromegaly, an underlying androgen-secreting tumor that may be malignant must be ruled out [4]. We are reporting here a rare case of virilizing androgenic tumor of ovary in a postmenopausal woman with only complaint of severe alopecia
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