Pure Ovarian Leydig Cell Tumors

Abstract

Pure Leydig cell tumors are rare ovarian steroid cell neoplasms composed entirely or predominantly of Leydig cells. More than 75% of patients present signs of virilization due to overproduction of testosterone. We report the clinical manifestations, diagnosis, and treatment of a case of pure Leydig cell tumor at the Gynecology Department of Santa Casa de Misericórdia (Mercy Hospital) in Vitória, Espírito Santo State, Brazil, in 2002. The case was a 47-year-old female with progressive signs of virilization for more than five years. Laboratory examination revealed only high levels of serum testosterone. There was no evidence of alteration in adrenal glands during diagnostic imaging. Transvaginal ultrasound showed only a slightly enlarged right ovary, with no radiological sign of tumor. Total hysterectomy and bilateral salpingoophorectomy were performed. Histopathology and immunohistochemistry confirmed the diagnosis of pure Leydig cell tumor. After surgery, testosterone level returned to normal and there was no significant evidence of virilization.