ovarian hyperthecosis

Epidemiology

• rare

Pathology

• abnormal regulation of ovarian steroidogenesis
• hyperandrogenism
• bilateral ovarian enlargement
• with stromal hyperthecosis, assess endometrium for hyperplasia & carcinoma

Clinical manifestations

• hirsutism
• alopecia
• deepening of voice

Laboratory

• serum testosterone elevated
• serum free testosterone elevated
• serum DHEA may be normal
• serum FSH normal
• serum LH normal
• serum estradiol normal
• serum prolactin normal
• serum cortisol normal
• serum TSH normal
• serum glucose
• HgbA1c

Radiology

• transvaginal ultrasonography

Complications

• severe insulin resistance occurs
  • acanthosis nigricans
  • diabetes mellitus

Management

• hysterectomy & bilateral salpingo-oophorectomy (TAH-BSO)
• GnRH agonist for patients who are not surgical candidates

More general terms

• ovarian disease