Virilization of a postmenopausal woman by a mucinous cystoadenoma

OBJECTIVE: To describe the case of the most hyperandrogenaemic ovarian mucinous cystadenoma reported to date. METHODS: We present the clinical, laboratory and radiologic findings in a patient with an unusual diagnosis according to age and the clinical behaviour of the tumour, as well as a review of relevant literature. RESULTS: A 77-year-old women came to our consult because of fronto-parietal alopecia and an augmentation of the abdominal perimeter since 1 year ago. Clitoromegaly was observed during the physical examination. Hormonal analysis showed elevated testosterone and dehydroepiandrostenerone-sulphate levels (659 ng/dL and 1950 ng/ml, respectively), and imaging examination described an andexal cystic mass dependent on the right ovary. Pathological diagnosis was “mucinous cystoadenoma”. After surgery, clinical and analytical alterations were normalized. CONCLUSION: Although ovarian mucinous cystadenomas are classically classified as “nonfunctional” tumours, they exceptionally can act as functional, and produce testosterone levels as high as directly secreting hormones or germ cell tumours.