What are the signs of androgen-secreting tumors in women?

From the Guidelines

Androgen-secreting tumors in women are characterized by signs such as hirsutism, deepening of the voice, and oligo/amenorrhea, as noted in a study on neuroendocrine tumors published in the Journal of the National Comprehensive Cancer Network 1. These symptoms can be distinguished from other causes of hyperandrogenism by their rapid onset over months. Key signs include:

• Hirsutism
• Deepening of the voice
• Oligo/amenorrhea Other general tumor symptoms may also be present, such as abdominal or pelvic pain, a palpable mass, or unexplained weight loss. The diagnosis of androgen-secreting tumors is supported by laboratory findings of markedly elevated testosterone levels and other androgens like DHEA-S, particularly if the tumor is adrenal in origin, as reported in the study on neuroendocrine tumors 1. The ovaries and adrenal glands are the most common sources of these tumors. Any woman presenting with sudden, progressive virilization should undergo immediate evaluation with hormone level testing and imaging studies to locate the potential tumor source, given the potential for significant morbidity and impact on quality of life associated with these tumors.

From the Research

Signs of Androgenic Secreting Tumours in Women

• Hirsutism, defined as excessive growth of terminal hair in a male-like pattern, is a common sign of androgen-secreting tumours in women 2, 3, 4
• Other signs include acne, frontal/male pattern balding, and in severe cases, virilization 2, 3
• Clitoris hypertrophy, increase of muscle mass, irregular menstrual cycle, and metabolic syndrome can also accompany this condition 3
• Virilization is a relatively uncommon feature of hyperandrogenemia and its presence often suggests an androgen-producing tumor 3, 5

Diagnostic Considerations

• A thorough history, a focused clinical examination, and an interdisciplinary approach together with gynecologists and endocrinologists are extremely helpful in the diagnostic evaluation and therapy of patients with suspected hyperandrogenism 3
• Diagnostic tools including laboratory tests and imaging studies should also be engaged 2
• When evaluating a patient for hyperandrogenism, it is important to assess the severity of symptoms but most of all it is critical to assess the time of onset and dynamics of symptom progression 2

Specific Tumours

• Sertoli-Leydig Cell Tumors are the most frequent androgen-secreting neoplasms and constitute about 0.5% of all ovarian neoplasms 2, 5
• These tumors are usually unilateral and benign, and typically affect women under 30 years of age, but can also occur in postmenopausal women 2, 5