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Old 03-31-2015
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Question Gynecologic Pathology

A 25 year old G2P1 in her second trimester starts to notice increased hair on her face and belly. Otherwise has no other complaints. Physical examination shows a BP:110/70 and a pulse of 105 with a temperature of 27.6C. While examining the patient the Gynecologist notices bilateral enlarged masses in the RLQ and LLQ. U/S shows bilateral cystic enlarged ovaries. Serum workup shows elevated serum Testosterone and Androstenidione.
The patients continues her pregnancy and revisits her doctor a month postpartum (Baby had clitoromegaly). Patient's physical examination is normal and the bilateral masses are non palpable with a normal pelvic U/S. Which pathology caused the patient's Hirsutism?

A-Polycystic Ovarian Syndrome
B-Aromatase deficiency
C-Theca Leutin Cysts
D- Ovarian Cancer
E-Mayer-Rokitansky-Küster-Hauser syndrome
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Old 03-31-2015
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Theca lutein cysts

Last edited by Hassan8; 03-31-2015 at 07:51 AM.
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Old 03-31-2015
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Polycystic ovarian syndrome?
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Old 04-01-2015
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Any other answers?
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Old 04-01-2015
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theca lutein cysts
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Old 04-01-2015
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If it weren't for the masses i would've gone for aromatase deficiency but in this case i think its theca lutein cysts due to bilateral masses.
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Old 04-01-2015
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Correct Answer

Actually it's aromatase deficiency

Pay attention to what I asked for in the question, I didn't ask what pathology this patient had, I asked what was the cause of her hersutism.

PCOS, is wrong as they're infertile so they can' get pregnant and definitely the hirsutism isn't something that would start mid-pregnancy

Theca Lutein cyst is a "normal" manifestation that can be observed in some normal pregnancies due to the effect B-hCG. Itself has nooooothing to do with Testosterone that caused the hirsutism and the clitoromegaly in the child. I used this as a distractor

Mayer-Rokitansky-Küster-Hauser syndrome is Agenisis or Aplasia of the vagina and uterus
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