Virilism is the masculinization and enhancement of male secondary sexual characteristics in females. The etiology is usually of adrenal or ovarian origin. Here we report a case of virilizing Leydig cell type,
steroid cell
tumor of the left ovary, in a 40 year old female who presented with clinical signs and symptoms of
virilization: deepening of voice,
hirsutism (Ferriman-Gallwey score 26), clitoromegaly, and
androgenic alopecia. On further evaluation, laboratory investigations revealed
hyperandrogenism in the male range. Basal
testosterone values were elevated. Folicle Stimulating
Hormone and Luteinising
Hormone levels were within normal limits.
Dexamethasone suppression test did not alter
cortisol or
testosterone levels. An ovarian mass was confirmed radiologically. Following a total abdominal
hysterectomy with bilateral salpingoophorectomy, histopathological studies confirmed a left sided
steroid-cell ovarian
tumor, Leydig cell type (stage T(1)N(0)M(0)), which proved to the etiology of
virilization in this patient. Post-operatively her serum
testosterone levels declined with near-complete reversal of symptoms over time.