Abstract

ABSTRACT Leydig cell ovarian tumors, rare sex cord-gonadal stromal tumors constituting less than 0.5% of all ovarian tumors, pose both medical and social challenges, particularly for women presenting with symptoms of hirsutism. This study examines the histopathological features of a total abdominal hysterectomy specimen, including bilateral tubes and ovaries, from a 43-year-old female with progressive virilization, deepened voice, and hirsutism over six months. Imaging revealed an ovarian lump, prompting surgical intervention. Histopathological examination of the right ovarian section revealed tumor cells arranged in sheets, nests, and clusters, characterized by polygonal shapes, eosinophilic granular cytoplasm, uniform round nuclei, and prominent nucleoli, along with occasional binucleated and multinucleated cells. Immunohistochemistry (IHC) for Calretinin and Inhibin A was advised, confirming features suggestive of a Leydig cell tumor. The remaining endometrial tissue appeared normal. This case underscores the importance of considering hormonally active ovarian tumors, along with adrenal cancers, in diagnosing postmenopausal hyperandrogenism. Timely diagnosis and treatment through a multidisciplinary approach can lead to significant symptom improvement, as observed in this patient following tumor removal.

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