The clinical features and reproductive prognosis of ovarian neoplasms with hyperandrogenemia: a retrospective analysis of 33 cases

Abstract

The aim of this study is to review the natural course, clinical features, and reproductive prognosis of ovarian tumors associated with hyperandrogenemia. We retrospect 33 patients of ovarian tumors with hyperandrogenemia. Thirty cases (91%) were sex cord–stromal tumors. Sertoli-Leydig cell tumors, Leydig cell tumors, and steroid cell tumors were the most common types. It is not possible, to predict the pathological subtypes based on androgen levels alone. Most of these tumors were solid masses, with an average diameter of 3.9 cm. These tumors are soft or fragile, no clear boundary with normal tissue, thus excision is superior to exfoliation. The average disease course of the top three tumors was 32.6, 35.4, and 67.7 months, respectively. Among 11 married women with a desire to get pregnant, nine cases resumed menstrual periods after surgery and became pregnant naturally. Hyperandrogenemia might predict a better prognosis. The asynchronism of hyperandrogenemia and undetectable tumor may cause irreversible change and emotional depress, the methods of early diagnosis need further study.

Chinese abstract

本研究的目的旨在探讨卵巢肿瘤伴高雄激素血症的自然病程、临床特点以及生殖预后。我们回顾了33例卵巢肿瘤合并高雄激素血症的临床资料。30例患者 (91%) 为卵巢性索间质肿瘤。支持细胞-间质细胞瘤、间质细胞肿瘤以及类固醇细胞肿瘤是最常见的类型。仅仅根据雄激素的水平来预测病理分型是不可能的。肿瘤中大多数为实性肿块, 平均直径为3.9厘米。这些肿瘤是软的或者脆的, 与正常组织相比没有清晰的界限, 因此切除的方法是优于剥离的。前三位肿瘤的平均病程分别为32.6个月, 35.4个月以及67.7个月。在11个有怀孕愿望的已婚妇女中, 有9名妇女在术后重新恢复月经并自然受孕。高雄激素血症可能预示着预后良好。高雄激素血症与未检出肿瘤的不同步可能造成不可逆的改变以及情绪低落, 早期诊断的方法有待进一步的研究。

Keywords:

• Hyperandrogenemia
• ovarian neoplasms
• clinical features
• hirsutism
• acne
• clitoral hypertrophy

Disclosure statement

The authors declare that they have no conflict of interest.