Androgen-Secreting Ovarian Tumors.

2区医学 Q2 Medicine

Frontiers of Hormone Research Pub Date : 2019-01-01 DOI:10.1159/000494906

D. Macut, Dusan S Ilic, A. Mitrović Jovanović, J. Bjekić-Macut

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引用次数: 12

Abstract

About 1% of ovarian tumors that comprise testicular cell types can cause hyperandrogenism followed by characteristic virilization. Androgenic group of tumors originated mainly from sex-cord stromal ovarian tumors are including steroid cell tumors, Leydig tumors, granulosa cell tumors, Sertoli cell tumors, Sertoli-Leydig cell tumors, gonadoblastomas, and some other rare forms as ovarian metastases from neuroendocrine tumors. Germline or somatic mutations in some genes like DICER1, STK11, and FOXL2 are associated with the development of some sex cord-stromal ovarian tumors. Basal serum testosterone concentrations above 7 nmol/L could indicate an androgen-secreting tumor. Other ovarian and adrenal androgens should be determined and functional endocrine testing including low-dose dexamethasone suppression test, gonadotrophin-releasing hormone (GnRH) agonist test, imaging methods, and selective venous sampling should be performed. Surgery is the first-line treatment for most of the tumors. Women who are not good surgical candidates could benefit from use of GnRH agonist to control hyperandrogenism. In some cases, chemotherapy and/or radiation therapy is required while some tumors respond on antiangiogenic agents used alone or in combination with chemotherapy. Metabolic implications and long-term outcomes of ovarian androgen-secreting tumors are unknown and require more detailed follow-up in multicentric and longitudinal clinical studies.

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分泌雄激素的卵巢肿瘤。

由睾丸细胞类型组成的卵巢肿瘤中约有1%可引起雄激素过多，随后出现特征性男性化。雄激素组肿瘤主要起源于性索间质卵巢肿瘤，包括类固醇细胞瘤、间质瘤、颗粒细胞瘤、支持细胞瘤、支持-间质细胞瘤、性腺母细胞瘤以及其他一些罕见的卵巢转移性神经内分泌肿瘤。一些基因如DICER1、STK11和FOXL2的种系或体细胞突变与一些性索间质卵巢肿瘤的发生有关。基础血清睾酮浓度高于7 nmol/L提示为雄激素分泌型肿瘤。应检测其他卵巢和肾上腺雄激素，并进行内分泌功能检测，包括低剂量地塞米松抑制试验、促性腺激素释放激素(GnRH)激动剂试验、影像学检查和选择性静脉取样。手术是大多数肿瘤的一线治疗方法。不适合外科手术的妇女可以从使用GnRH激动剂来控制高雄激素症中获益。在某些情况下，需要化疗和/或放射治疗，而一些肿瘤对单独使用抗血管生成药物或与化疗联合使用有反应。卵巢雄激素分泌肿瘤的代谢影响和长期预后尚不清楚，需要在多中心和纵向临床研究中进行更详细的随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers of Hormone Research 医学-内分泌学与代谢

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期刊介绍： A series of integrated overviews on cutting-edge topics New sophisticated technologies and methodological approaches in diagnostics and therapeutics have led to significant improvements in identifying and characterizing an increasing number of medical conditions, which is particularly true for all aspects of endocrine and metabolic dysfunctions. Novel insights in endocrine physiology and pathophysiology allow for new perspectives in clinical management and thus lead to the development of molecular, personalized treatments. In view of this, the active interplay between basic scientists and clinicians has become fundamental, both to provide patients with the most appropriate care and to advance future research.