Cargando…
SAT384 Is This A Case of Androgen-Secreting Endometrial Cancer in A Postmenopausal Woman?
Disclosure: V. Taqi: None. P. rimal: None. J.L. Gilden: None. Background: Hirsutism (HIR) is a common disorder of women of reproductive age, often due to polycystic ovary syndrome (PCOS). During post menopause (PM), there is usually diminishment of androgenizing hormone levels and symptoms associate...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555358/ http://dx.doi.org/10.1210/jendso/bvad114.1689 |
_version_ | 1785116637922328576 |
---|---|
author | Taqi, Vian Rimal, Priya Gilden, Janice L |
author_facet | Taqi, Vian Rimal, Priya Gilden, Janice L |
author_sort | Taqi, Vian |
collection | PubMed |
description | Disclosure: V. Taqi: None. P. rimal: None. J.L. Gilden: None. Background: Hirsutism (HIR) is a common disorder of women of reproductive age, often due to polycystic ovary syndrome (PCOS). During post menopause (PM), there is usually diminishment of androgenizing hormone levels and symptoms associated with PCOS. However, rapidly progressive HIR and symptoms of virilization in PM women should always raise the question of androgen-secreting tumors, whether of ovarian or adrenal origin. Other rare causes include ovarian hyperthecosis and Leydig cell hyperplasia. We present a rare case of hyperandrogenism with endometrial carcinoma, associated with increasing hirsutism and normal ovarian imaging and pathology. Clinical case: A 56-year-old woman G3P3 PM for 2 yrs, with Type 2 Diabetes, obesity, HTN, hypercholesterolemia, IBS, Factor S Leiden, menarche at age 12-13 yrs, and PCOS s/p laser HIR removal, and previous regular menses, was referred to endocrine clinic for increasing HIR with diffuse hair loss for 6 months and suprapubic/abdominal discomfort. She also had prior corneal melanoma treated with radiation and cardiac ablation for arrhythmia. Her paternal grandmother had uterine cancer. Physical Exam: VS BP=121/78; HR=66; BMI=31 Kg/m²: (Ferriman-Gallwey score 16/36) with HIR on face, abdomen, chest and back, but no other virilization or cushingoid signs. Initial labs: elevated total and free testosterone (59 ng/dl, n<45), (9.3 pg/ml, n<6.4) respectively, unconjugated DHEA (55 ng/dL, n 77-85) low DHEA-S (29 mcg/dl, n 35- 430 mcg/dl) 17-OHP (50 ng/dL, repeat 44 (n≤ 45) with normal prolactin (5.4 ng/mL, n 0.7-31.6) ACTH (7 pg/mL, n 0-47), salivary cortisol <0.03 mcg/dL, FSH (50.3 mIU/mL ;n=5.9-72.8), LH (29.7 mIU/ml, n 1.1-52.4), estradiol (21.71 pg/mL (n <11-32.2). CT abdomen-hepatic steatosis, normal adrenals. US- heterogenous mass uterine fundus 1.1 x 1.0 x 1.0 cm with subendometrial calcifications, subcm follicles in ovaries. MRI-hypoechoic 0.7X0.8X0.7 cm uterine lesion, normal ovaries; Endometrial biopsy-disordered proliferative endometrium. Hysteroscopy with biopsy confirmed grade I endometrial adenocarcinoma. A total laparoscopic abdominal hysterectomy with bilateral oophorectomy (TAH/BSO) was performed. Pathology-endometrial carcinoma, endometroid type F1GO stage 1A with positive estrogen and progesterone receptors, normal ovaries. By 3 months postop, the HIR significantly decreased with normalized total and free testosterone levels (14 ng/dl), (1.8 pg/ml). Conclusion: This is a rare case of hyperandrogenism associated with endometrial cancer in a postmenopausal woman causing hirsutism with the resolution of symptoms and normalization of androgen levels following TAH/BSO. Clinicians should be aware to thoroughly evaluate postmenopausal women who develop sudden increasing signs of androgenization, particularly if it is of recent onset, and consider other rare diagnoses. Presentation Date: Saturday, June 17, 2023 |
format | Online Article Text |
id | pubmed-10555358 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105553582023-10-06 SAT384 Is This A Case of Androgen-Secreting Endometrial Cancer in A Postmenopausal Woman? Taqi, Vian Rimal, Priya Gilden, Janice L J Endocr Soc Reproductive Endocrinology Disclosure: V. Taqi: None. P. rimal: None. J.L. Gilden: None. Background: Hirsutism (HIR) is a common disorder of women of reproductive age, often due to polycystic ovary syndrome (PCOS). During post menopause (PM), there is usually diminishment of androgenizing hormone levels and symptoms associated with PCOS. However, rapidly progressive HIR and symptoms of virilization in PM women should always raise the question of androgen-secreting tumors, whether of ovarian or adrenal origin. Other rare causes include ovarian hyperthecosis and Leydig cell hyperplasia. We present a rare case of hyperandrogenism with endometrial carcinoma, associated with increasing hirsutism and normal ovarian imaging and pathology. Clinical case: A 56-year-old woman G3P3 PM for 2 yrs, with Type 2 Diabetes, obesity, HTN, hypercholesterolemia, IBS, Factor S Leiden, menarche at age 12-13 yrs, and PCOS s/p laser HIR removal, and previous regular menses, was referred to endocrine clinic for increasing HIR with diffuse hair loss for 6 months and suprapubic/abdominal discomfort. She also had prior corneal melanoma treated with radiation and cardiac ablation for arrhythmia. Her paternal grandmother had uterine cancer. Physical Exam: VS BP=121/78; HR=66; BMI=31 Kg/m²: (Ferriman-Gallwey score 16/36) with HIR on face, abdomen, chest and back, but no other virilization or cushingoid signs. Initial labs: elevated total and free testosterone (59 ng/dl, n<45), (9.3 pg/ml, n<6.4) respectively, unconjugated DHEA (55 ng/dL, n 77-85) low DHEA-S (29 mcg/dl, n 35- 430 mcg/dl) 17-OHP (50 ng/dL, repeat 44 (n≤ 45) with normal prolactin (5.4 ng/mL, n 0.7-31.6) ACTH (7 pg/mL, n 0-47), salivary cortisol <0.03 mcg/dL, FSH (50.3 mIU/mL ;n=5.9-72.8), LH (29.7 mIU/ml, n 1.1-52.4), estradiol (21.71 pg/mL (n <11-32.2). CT abdomen-hepatic steatosis, normal adrenals. US- heterogenous mass uterine fundus 1.1 x 1.0 x 1.0 cm with subendometrial calcifications, subcm follicles in ovaries. MRI-hypoechoic 0.7X0.8X0.7 cm uterine lesion, normal ovaries; Endometrial biopsy-disordered proliferative endometrium. Hysteroscopy with biopsy confirmed grade I endometrial adenocarcinoma. A total laparoscopic abdominal hysterectomy with bilateral oophorectomy (TAH/BSO) was performed. Pathology-endometrial carcinoma, endometroid type F1GO stage 1A with positive estrogen and progesterone receptors, normal ovaries. By 3 months postop, the HIR significantly decreased with normalized total and free testosterone levels (14 ng/dl), (1.8 pg/ml). Conclusion: This is a rare case of hyperandrogenism associated with endometrial cancer in a postmenopausal woman causing hirsutism with the resolution of symptoms and normalization of androgen levels following TAH/BSO. Clinicians should be aware to thoroughly evaluate postmenopausal women who develop sudden increasing signs of androgenization, particularly if it is of recent onset, and consider other rare diagnoses. Presentation Date: Saturday, June 17, 2023 Oxford University Press 2023-10-05 /pmc/articles/PMC10555358/ http://dx.doi.org/10.1210/jendso/bvad114.1689 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Reproductive Endocrinology Taqi, Vian Rimal, Priya Gilden, Janice L SAT384 Is This A Case of Androgen-Secreting Endometrial Cancer in A Postmenopausal Woman? |
title | SAT384 Is This A Case of Androgen-Secreting Endometrial Cancer in A Postmenopausal Woman? |
title_full | SAT384 Is This A Case of Androgen-Secreting Endometrial Cancer in A Postmenopausal Woman? |
title_fullStr | SAT384 Is This A Case of Androgen-Secreting Endometrial Cancer in A Postmenopausal Woman? |
title_full_unstemmed | SAT384 Is This A Case of Androgen-Secreting Endometrial Cancer in A Postmenopausal Woman? |
title_short | SAT384 Is This A Case of Androgen-Secreting Endometrial Cancer in A Postmenopausal Woman? |
title_sort | sat384 is this a case of androgen-secreting endometrial cancer in a postmenopausal woman? |
topic | Reproductive Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555358/ http://dx.doi.org/10.1210/jendso/bvad114.1689 |
work_keys_str_mv | AT taqivian sat384isthisacaseofandrogensecretingendometrialcancerinapostmenopausalwoman AT rimalpriya sat384isthisacaseofandrogensecretingendometrialcancerinapostmenopausalwoman AT gildenjanicel sat384isthisacaseofandrogensecretingendometrialcancerinapostmenopausalwoman |