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Woman with virilizing congenital adrenal hyperplasia and leydig cell tumor of the ovary
Authors:Rosario Fernández-García Salazar  Carmen Muñoz-Darias  Juan Jesús Haro-Mora  M. Cruz Almaraz  Laura Audí  Juana Martínez-Tudela
Affiliation:1. Endocrinology Department, Andalusian Gender Team, IBIMA, Carlos Haya HospitalMalagaSpain;2. Endocrinology Department, N.S. Candelaria University HospitalTenerifeSpain;3. Endocrinology and Investigation Department. IBIMA. Carlos Haya HospitalMalagaSpain;4. Paediatrics Department, Investigation Institute Hospital Vall d’Hebron, Autonomous University of BarcelonaCIBERERSpain;5. Psychology Department, Andalusian Gender Team, Carlos Haya HospitalMalagaSpain
Abstract:We report the case of a 36-year-old woman with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, and corticosteroid replacement therapy since birth. She manifested persistent virilization and high testosterone levels that were attributed to nonadherence to medical treatment. The patient was referred to our gender unit for genitoplastic surgery. We recommended the patient for left oophorectomy after detecting an ovarian mass. Pathologic findings confirmed an ovarian hilus cell tumor. Testosterone levels fell back to normal and masculinization disappeared but ACTH remained elevated. This case represents a very rare type of primary ovarian tumor that must be considered in persistent virilizing symptoms in women with CAH.
Keywords:Congenital adrenal hyperplasia  leydig cell tumor  ovarian hilus cells tumor  virilization
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