Sertoli-Leydig cell tumor in a patient with hyperandrogenism: New approaches to diagnosis

The article presents a clinical case of a 55-year-old woman who was diagnosed with hyperplasia of the medial pedicle of the left adrenal gland and the formation of the left ovary against the background of pronounced manifestations of hyperandrogenism syndrome: androgen-dependent alopecia, hirsutism, arterial hypertension, fasting and postprandial hyperglycemia. Hyperandrogenism was confirmed by laboratory tests, the hormonal activity of the left adrenal hyperplasia was excluded. Using gas chromatography-mass spectrometry of daily urine and selective blood sampling from the ovarian veins with an assessment of the concentration of androstenedione and testosterone, the ovarian origin of hyperandrogenism syndrome was proved. The patient underwent laparoscopic extirpation of the uterus and appendages, followed by regression of symptoms. The normalization of hormones was biochemically confirmed after 3 months. The clinical case demonstrates the high sensitivity and specificity of gas chromatography-mass spectrometry, highlighting the importance of this method for the differential diagnosis of adrenal and gonadal diseases.