A feminizing Sertoli‐Leydig cell tumour in a postmenopausal woman. Case report

In November 1984 a 73-year-old woman, para 4+ 1, attended for routine examination. She had her last menstrual period at the age of 58 and underwent a curettage for postmenopausal bleeding 5 years later; an endometrial mucous polyp was removed and the endometrium was found to be atrophic. She was given oestrogen replacement therapy (oestriol 2 mg per day) until the age of 68. She was in good general health, body weight 55 kg, height 159 cm, and there were no signs of virilization. The vaginal mucosa was welloestrogenized as illustrated by the dominance of superficial and intermediate cells in the vaginal smear. A left-sided mobile, solid adnexal mass, the size of an orange, was found on pelvic examination and this was confirmed by echography. Serum concentrations of luteinizing hormone and follicle stimulating hormone were 33.6 m-i.u./ml and 11.0 m-i.u./ml; the concentration of oestradiol (EJ was 0.65 nmoVl and of testosterone (T) 2-26 nmol/l. Haemoglobin and haematocrit values were normal. A uterine curettage was performed because the patient had experienced some vaginal bleeding a few days after the first visit. The endometrium showed signs of cystic glandular hyperplasia. The presence of a left-sided ovarian tumour was confirmed at laparotomy; it was semicystic, 6 x5 x 4cm, well encapsulated and not