Diagnostic Challenges in Ovarian Hyperthecosis: Clinical Presentation with Subdiagnostic Testosterone Levels

Symptoms of hyperandrogenism and virilization in postmenopausal women warrant workup for ovarian hyperthecosis. In this case series, we discuss two patients who presented with symptoms of hyperandrogenism and metabolic abnormalities including insulin resistance stemming from ovarian hyperthecosis. I...

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Main Authors: Sanket Shah, Callie Torres, Naser Gharaibeh
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2022/9998807
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author Sanket Shah
Callie Torres
Naser Gharaibeh
author_facet Sanket Shah
Callie Torres
Naser Gharaibeh
author_sort Sanket Shah
collection DOAJ
description Symptoms of hyperandrogenism and virilization in postmenopausal women warrant workup for ovarian hyperthecosis. In this case series, we discuss two patients who presented with symptoms of hyperandrogenism and metabolic abnormalities including insulin resistance stemming from ovarian hyperthecosis. Imaging revealed normal ovaries in both patients. However, both patients had total serum testosterone levels below the lower diagnostic limit for ovarian hyperthecosis. Due to high clinical suspicion of ovarian hyperthecosis, both patients underwent bilateral oophorectomy without venous sampling for ovarian androgens. The diagnosis of ovarian hyperthecosis was confirmed on histological examination. Both women had improvement in their hyperandrogenic symptoms, testosterone levels, and biochemical features of insulin resistance after surgical intervention. This presentation of ovarian hyperthecosis with subdiagnostic total serum testosterone levels demonstrates the need for continued research into the pathophysiology of the disease, discussion of the diagnostic threshold of total serum testosterone, as well as the inclusion of ovarian hyperthecosis in the differential of postmenopausal women with hyperandrogenism and insulin resistance.
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spelling doaj-art-9e65e74cc6ea45048fd190e080fc059b2025-02-03T06:11:19ZengWileyCase Reports in Endocrinology2090-651X2022-01-01202210.1155/2022/9998807Diagnostic Challenges in Ovarian Hyperthecosis: Clinical Presentation with Subdiagnostic Testosterone LevelsSanket Shah0Callie Torres1Naser Gharaibeh2Department of Internal MedicineDepartment of Pathology & ImmunologyDepartment of EndocrinologySymptoms of hyperandrogenism and virilization in postmenopausal women warrant workup for ovarian hyperthecosis. In this case series, we discuss two patients who presented with symptoms of hyperandrogenism and metabolic abnormalities including insulin resistance stemming from ovarian hyperthecosis. Imaging revealed normal ovaries in both patients. However, both patients had total serum testosterone levels below the lower diagnostic limit for ovarian hyperthecosis. Due to high clinical suspicion of ovarian hyperthecosis, both patients underwent bilateral oophorectomy without venous sampling for ovarian androgens. The diagnosis of ovarian hyperthecosis was confirmed on histological examination. Both women had improvement in their hyperandrogenic symptoms, testosterone levels, and biochemical features of insulin resistance after surgical intervention. This presentation of ovarian hyperthecosis with subdiagnostic total serum testosterone levels demonstrates the need for continued research into the pathophysiology of the disease, discussion of the diagnostic threshold of total serum testosterone, as well as the inclusion of ovarian hyperthecosis in the differential of postmenopausal women with hyperandrogenism and insulin resistance.http://dx.doi.org/10.1155/2022/9998807
spellingShingle Sanket Shah
Callie Torres
Naser Gharaibeh
Diagnostic Challenges in Ovarian Hyperthecosis: Clinical Presentation with Subdiagnostic Testosterone Levels
Case Reports in Endocrinology
title Diagnostic Challenges in Ovarian Hyperthecosis: Clinical Presentation with Subdiagnostic Testosterone Levels
title_full Diagnostic Challenges in Ovarian Hyperthecosis: Clinical Presentation with Subdiagnostic Testosterone Levels
title_fullStr Diagnostic Challenges in Ovarian Hyperthecosis: Clinical Presentation with Subdiagnostic Testosterone Levels
title_full_unstemmed Diagnostic Challenges in Ovarian Hyperthecosis: Clinical Presentation with Subdiagnostic Testosterone Levels
title_short Diagnostic Challenges in Ovarian Hyperthecosis: Clinical Presentation with Subdiagnostic Testosterone Levels
title_sort diagnostic challenges in ovarian hyperthecosis clinical presentation with subdiagnostic testosterone levels
url http://dx.doi.org/10.1155/2022/9998807
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