Leydig Cell Tumor of Ovary in a Pre-Menopausal Woman: A rare case of Virilization

Abstract

Background: Leydig cell tumor, a rare type of ovarian steroid cell tumor shows signs of virilization due to overproduction of testosterone. The condition is difficult to identify without histopathological examination. Methods: The authors report a case of Leydig cell tumor in a 34-year-old woman who first presented with severe clinical hyperandrogenism and associated complex medical history. Results: Investigations revealed markedly raised serum concentrations of total testosterone (680 ng/dL) (Normal reference values 02-45 ng/dL for adult woman), whereas prolactin, luteinizing hormone (LH) and follicle stimulating hormone (FSH), cortisol were all within the normal range. Transabdominal ultrasound and computed tomography (CT) scan of the pelvis and abdomen showed a bulky right ovary, but no other abnormalities. An ovarian source of androgens was suspected and surgery was arranged. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathologically the case was diagnosed as Leydig cell tumor within the right ovary. After surgery, androgen levels returned to normal, and there was regression of the signs of virilization. Conclusion: Virilizing Leydig cell tumors usually have a benign behavior, with an excellent prognosis and reversion of symptoms after surgical treatment.