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
- Post menopausal women: Androgen producing tumors such as Sertoli-Leydig cell tumor (image studies for discrete mass)
- Premenopausal women
- Polycystic ovary disease, image studies, pathological features
- Androgen producing tumors, very rare
- Surgery: Bilateral oophorectomy
- GnRH agonist
- Oral contraceptive for premenopausal patients
- Treatments of diabetes, obesity, etc
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