MASSIVE OVARIAN EDEMA WITH ANDROGEN SECRETION - A PATHOLOGICAL AND ENDOCRINE STUDY WITH REVIEW OF THE LITERATURE

A case of massive edema of the left ovary with virilization is describ ed. Microscopically, massive interstitial edema with luteinization of theca and stromal cells was found. A few stromal cells contained Reink e-type crystalloids - an original observation. Peripheral concentratio ns of testosterone, dihydrotestosterone and androstenedione were incre ased. Ratios of left ovarian vein to peripheral vein concentrations we re increased for all these steroids as well as for estradiol and estro ne, showing that the left ovary was the source of excess androgen and estrogen secretion. The patient showed impaired gonadotropin secretion in basal conditions and after an intravenous luteinizing-hormone-rele asing hormone (LHRH) stimulation test. After left oophorectomy, all st eroids and gonadotropin response to LHRH returned to normal, and viril ization regressed. Analysis of the endocrine changes associated with t his ovarian tumor brings additional arguments for a primary role of hy perandrogenism in the impairment of gonadotropin secretion, as was als o observed in other hyperandrogenic disorders including polycystic ova rian syndrome.