Differential diagnosis of adipocytic differentiation in androgen-secreting mature ovarian teratoma with Leydig cell hyperplasia.
Mpatsoulis, Diogenis Nieto J, Joaquin Lonsdale, Ray Fisher, Cyril Mazibrada, Jasenka
Mpatsoulis, Diogenis
Nieto J, Joaquin
Lonsdale, Ray
Fisher, Cyril
Mazibrada, Jasenka
Abstract
Mature cystic teratomas (dermoid cysts) of the ovary are very rarely associated with androgen production. The source of androgens in these cysts may be tumours such as Sertoli-Leydig cell tumour or Leydig cell hyperplasia. In this study, we present a case of virilisation in a postmenopausal female patient, where Leydig cell hyperplasia in a mature cystic teratoma was found to be responsible for the production of testosterone. In addition, extensive areas of lipomatous differentiation were identified. These areas showed significant alterations in adipocytic morphology, and differential diagnoses such as spindle cell lipoma (SCL) and atypical lipomatous tumour (ALT) were excluded after additional workup. Adipose tissue is traditionally described as an energy reservoir, but recently it has become clear that adipose tissue is a complex endocrine organ with additional metabolic roles in whole body homeostasis. Exuberant proliferation of lipomatous tissue in this teratoma raises the possibility of a synergistic role of Leydig cells and adipocytes in the development of hyperandrogenism.
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Date
2021-05-08
Type
Article
Other
Other
Subject
Oncology. Pathology.
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Citation
Mpatsoulis D, Nieto J J, Lonsdale R, Fisher C, Mazibrada J. Differential diagnosis of adipocytic differentiation in androgen-secreting mature ovarian teratoma with Leydig cell hyperplasia. Gynecol Oncol Rep. 2021 May 8;36:100786. doi: 10.1016/j.gore.2021.100786
Journal / Source Title
Gynecologic Oncology Reports
DOI
10.1016/j.gore.2021.100786
PMID
34036140
Publisher
Elsevier
Publisher’s URL
http://www.sciencedirect.com/science/journal/23525789