Alopécie de type androgénétique révélatrice d’une tumeur sécrétante de l’ovaire

Abstract

In menopausal women, rapid development of androgenetic alopecia may be associated with development of androgen-secreting tumors even in the absence of signs of virilisation. We report a case in which ovarian tumor was revealed by this condition. A 75 year-old woman menopausal from the age of 44 years had experienced hair loss over the previous three years with exacerbation over the last year. Clinical examination revealed male pattern androgenogenetic alopecia but with no signs of virilisation. Testosterone levels were 3 times the normal limit. Radiological examination confirmed the presence of an ovarian tumour and hysterectomy was performed with bilateral actomy. Histopathological examination revealed a mature cystic dysembryoma of the right ovary containing Leydig cell islets. The outcome was favourable with normalisation of hormone levels 2 months after surgery and gradual hair growth. This case involved a woman with androgenogenetic alopecia with no signs of virilisation or of hirsutism. The clinical picture was banal, and given the patient's age, there was no justification for routine endocrine investigation. Because of recent focus on androgenogenetic alopecia, testosterone levels were checked, resulting in the discovery of an ovarian tumour containing Leydig cells. In menopausal women with recent and/or severe androgenogenetic alopecia, testosterone levels should be determined in addition to ultrasensitive TSH and ferritin.