关键词: 雄激素增多症, 卵巢肿瘤, 肾上腺肿瘤

Abstract: Objective　To analyze the etiology，clinical manifestations and pathological features of androgen-secreting tumors（AST） in women，offering a reference for the diagnosis，treatment and prognosis improvement of the disease.Methods　Twenty patients with postsurgical pathology confirmed AST 〔AST arising from ovaries in 11 cases（ovary tumor group） and from adrenals in 9 cases（adrenal tumor group）〕 were recruited from Chinese PLA General Hospital between January 2012 and January 2018.A retrospective analysis was conducted on their personal characteristics，clinical manifestations，laboratory findings，imaging features，pathological features and prognosis.Results　The average age for ovary tumor group and adrenal tumor group was（37.4±20.2）（32.2±14.8） years old，respectively.The average duration of AST was（2.8±2.7） years（range：7 months to 10 years） for ovary tumor group，and（0.7±0.6） years（range：7 days to 2 years） for adrenal tumor group.All the cases in ovary tumor group showed virilism，and 10 showed de-feminization.In the adrenal tumor group，5 demonstrated virilism，and 4 demonstrated de-feminization.The serum levels of testosterone（T），17-hydroxyprogesterone（17-OHP），and dehydroepiandrosterone sulfate（DHEAS） were 14.1（9.0，25.4） nmol/L，（2.5±0.8） μg/L，（188±101） μg/dl，respectively for ovary tumor group，and 7.1（4.9，16.1） nmol/L，（6.2±3.3） μg/L，（676±312） μg/dl，respectively for adrenal tumor group.In the ovarian tumor group，10 were found with tumor by transvaginal ultrasonography，and other 1 was found by surgical exploration.The average diameter of the tumor was（5.2±3.2） cm，which had no linear correlation with serum T level（r=-0.50，P>0.05）.In the adrenal tumor group，the tumor was found by enhanced adrenal gland CT in all cases.The average diameter of tumor was（10.7±4.1） cm，which showed no linear correlation with serum T level（r=-0.23，P>0.05）.Postsurgical pathological test found that in the ovarian tumor group，3 were found with Sertoli-Leydig cell tumors，7 with ovarian steroid cell tumors，and 1 with teratoma；in the adrenal tumor group，3 were found with adrenocortical adenoma，and other 6 with adrenocortical adenocarcinoma.During the follow-up period，9 cases of ovarian tumors survived，but other 2 were lost to follow-up；4 cases of adrenal tumors survived，2 died，and other 3 were lost to follow-up.Conclusion　Both androgen-secreting ovarian tumors and androgen-secreting adrenal tumors could cause virilism and defeminization.Moreover，both of them could significantly increase the serum T level，but showed no significant difference in the growth level.Compared with patients with androgen-secreting ovarian tumors，those with androgen-secreting adrenal tumors had higher serum levels of 17-OHP and DHEAS，larger tumor diameter，and poorer prognosis.

Key words: Hyperandrogenism, Ovarian neoplasms, Adrenal gland neoplasms