Stromal hyperthecosis

Stromal hyperthecosis
Updated: 12/28/2018
© Jun Wang, MD, PhD

General features
  • Hyperplastic ovarian stroma with clusters of luteinized stromal cells
  • Typically seen in the 6th to 7th decade
  • Associated with androgen overproduction
Clinical presentations
  • Similar symptoms as polycystic ovarian syndrome, but higher testosterone levels and no/fewer cysts
  • Obese patients with striking virilization and insulin resistance
Key Laboratory findings
  • Elevated total and free testosterone: Sensitive
  • Normal or low FSH, LH
Key morphological features
  • Uniform enlargement of both ovaries
  • Nests of luteinized theca cells in ovarian stroma
Differential diagnosis
Treatment
  • Surgery: Bilateral oophorectomy
  • GnRH agonist
  • Oral contraceptive for premenopausal patients
  • Treatments of diabetes, obesity, etc



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