Diagnosis of an indistinct Leydig cell tumor by positron emission tomography-computed tomography

• Published in: Obstetrics & gynecology science Vol. 62; no. 3; pp. 194 - 198
• Main Authors: Kong, Jinkyoung, Park, Yoo Mee, Choi, Young Sik, Cho, SiHyun, Lee, Byung Seok, Park, Joo Hyun
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society 01.05.2019; Korean Society of Obstetrics and Gynecology; 대한산부인과학회
• Subjects: Case Report; diagnosis; pet-ct; sertoli-leydig cell tumor; 산부인과학; Sertoli-Leydig cell tumor; PET-CT; Diagnosis
• ISSN: 2287-8572; 2287-8580
• DOI: 10.5468/ogs.2019.62.3.194

A 51-year-old perimenopausal female patient presented with hirsutism and voice thickening which was started approximately one and a half years ago. Her initial hormone assay revealed elevated plasma testosterone, 5a-dihydrotestosterone, and dehydroepiandrosterone (DHEA) levels and therefore androgen-secreting tumor was first suspected. However, the lesion was inconspicuous on transvaginal sonography, abdominal-pelvic computed tomography (CT) scan, and pelvic magnetic resonance (MRI) imaging. Consequently, F-fluorodeoxyglucose (FDG) positron emission tomography-CT was performed, which localized the lesion as a focal FDG uptake within the right adnexa. Total laparoscopic hysterectomy with bilateral salpingo-oophorectomy was performed, and although visible gross mass lesions were not observed intraoperatively, pure Leydig cell tumor was pathologically confirmed within the right ovary. Plasma testosterone, 5a-dihydrotestosterone, and DHEA levels were normalized postoperatively. Clinical signs of virilization were also significantly resolved after 3-months of follow-up.