Year 2018, Volume 2 , Issue 3, Pages 374 - 376 2018-09-01

A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein
Ovaryen venlerin selektif kateterizasyonu ile tanı alan bir postmenapozal ovaryen hiperandrojenemi vakası

Vedat UĞUREL [1] , Mehmet Musa ASLAN [2] , Koray ELTER [3]


Hyperandrogenemia in a postmenopausal woman is usually related to a tumor in either ovaries or adrenal glands. To differentiate between these two endocrine organs is a diagnostic challenge when the tumor size is too small to be detected with the aid of usual imaging modalities. 54 years-old postmenopausal woman with signs of virilization was referred to our institution with serum total testosteron levels of 294 ng/dl. Contrast-enhanced computed tomography (CT) revealed a lesion consistent with the tumor 1 cm in diameter in the adrenal gland and magnetic resonance imaging (MRI) could not confirm this finding. The location of androgen hypersecretion could only be determined after selective venous catheterization and hormonal sampling of both adrenal and ovarian veins. The right ovarian venous total testosterone level was found as > 1009.40 ng / dl. A right-sided ovarian Leydig cell tumor was diagnosed in the specimen of laparoscopic hysterectomy and bilateral salpingo-oopherectomy. This case report underlines the importance to carry on the search with the selective venous catheterisation and hormonal sampling from both the ovarian and the adrenal veins when there is difficulty to demonstrate the true source of androgen hypersecretion in a postmenopausal woman. 

Postmenapozal dönemde hiperandrojenemi genellikle over veya adrenal bezlerdeki tümörlerle ilişkilidir. Her iki endokrin organdaki tümörlerin çapları çok küçük olduğunda görüntüleme yöntemleri tanıda yetersiz kalmaktadır. 54 yaşında postmenapozal hasta, klitoromegali ve artış gösteren hirsutizm bulguları olan hasta serum total testosteron seviyesi 294 ng/dl ile bölümümüze başvurdu. Kontrastlı bilgisayarlı tomografide (BT) adrenal bezde 1 cm çapında tümör ile uyumlu lezyon saptandı ancak manyetik rezonans (MR) ile bu bulgu teyit edilemedi. Androjen hipersekresyonunun orijininin tespit edilememesi üzerine bilateral ovaryen ve adrenal venlerin selektif venöz kateterizasyonu ve hormonal örneklemesi yapıldı. Sağ ovaryan ven total testosteron düzeyi >1009,40 ng/dl olarak bulundu. Laparoskopik histerektomi ve bilateral salpingooferektomi yapılan hastanın patoloji sonucu sağ over kaynaklı Leydin Hücreli Tümör olarak geldi. 

Bu olgu sunumunda, postmenopozal bir kadında androjen hipersekresyonu kaynağını bulunamadığında , hem ovaryen venden hem de adrenal venlerden selektif venöz kateterizasyon ve hormonal örnekleme yapmanın önemi vurgulanmaktadır.

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Primary Language en
Subjects Surgery
Journal Section Case report
Authors

Author: Vedat UĞUREL
Institution: TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI

Author: Mehmet Musa ASLAN (Primary Author)
Institution: Muş Devlet Hastanesi Kadın Hastalıkları ve Doğum Kliniği
Country: Turkey


Author: Koray ELTER
Institution: TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI

Dates

Publication Date : September 1, 2018

Bibtex @case report { josam424326, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2018}, volume = {2}, pages = {374 - 376}, doi = {10.28982/josam.424326}, title = {A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein}, key = {cite}, author = {Uğurel, Vedat and Aslan, Mehmet Musa and Elter, Koray} }
APA Uğurel, V , Aslan, M , Elter, K . (2018). A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein . Journal of Surgery and Medicine , 2 (3) , 374-376 . DOI: 10.28982/josam.424326
MLA Uğurel, V , Aslan, M , Elter, K . "A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein" . Journal of Surgery and Medicine 2 (2018 ): 374-376 <https://jsurgmed.com/en/pub/issue/36726/424326>
Chicago Uğurel, V , Aslan, M , Elter, K . "A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein". Journal of Surgery and Medicine 2 (2018 ): 374-376
RIS TY - JOUR T1 - A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein AU - Vedat Uğurel , Mehmet Musa Aslan , Koray Elter Y1 - 2018 PY - 2018 N1 - doi: 10.28982/josam.424326 DO - 10.28982/josam.424326 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 374 EP - 376 VL - 2 IS - 3 SN - -2602-2079 M3 - doi: 10.28982/josam.424326 UR - https://doi.org/10.28982/josam.424326 Y2 - 2018 ER -
EndNote %0 Journal of Surgery and Medicine A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein %A Vedat Uğurel , Mehmet Musa Aslan , Koray Elter %T A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein %D 2018 %J Journal of Surgery and Medicine %P -2602-2079 %V 2 %N 3 %R doi: 10.28982/josam.424326 %U 10.28982/josam.424326
ISNAD Uğurel, Vedat , Aslan, Mehmet Musa , Elter, Koray . "A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein". Journal of Surgery and Medicine 2 / 3 (September 2018): 374-376 . https://doi.org/10.28982/josam.424326
AMA Uğurel V , Aslan M , Elter K . A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein. J Surg Med. 2018; 2(3): 374-376.
Vancouver Uğurel V , Aslan M , Elter K . A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein. Journal of Surgery and Medicine. 2018; 2(3): 374-376.
IEEE V. Uğurel , M. Aslan and K. Elter , "A case of postmenopausal ovarian hyperandrogenemia diagnosed only by selective catheterization of ovarian vein", Journal of Surgery and Medicine, vol. 2, no. 3, pp. 374-376, Sep. 2018, doi:10.28982/josam.424326