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Old 11-04-2011
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Question Virilization and Amenorrhea in a 32 yr old woman!

A 32 year old woman has a 3 year history of oligomenorrhea that has progressed to amenorrhea she has observed loss of breast fullness, reduced hip measurements, acne, increased body hair, and deepening of her voice . physical examination reveals frontal balding, clitoral hypertrophy, and a male escutcheon. urinary free cortisol and DHEAS are normal. her plasma testosterone level is 6 ng/ml (normal is 0.2 to 0.8 ) which of the following is the most likely diagnosis ?

A) Cushing syndrome.
B) Arrhenoblastoma.
C) PCO.
D) Granulosa Theca Cell Tumor.
E) Ovarian Teratoma.
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  #2  
Old 11-04-2011
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B) Arrhenoblastoma.
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Old 11-04-2011
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PolyCystic Ovarian syndrome
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Old 11-04-2011
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Arrhenoblastoma
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Old 11-04-2011
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arrhenoblastoma... similar to leydig sertoli secretes high level of testosterone... PCO doest cause such a degree of high androgen to cause virilization... virilization think of adrenal tumour ( DHEAS wud be high) or ovarian tumour like this case
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Old 11-04-2011
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The correct answer is B.
The symptoms of masculinization in this patient are characteristic of an active androgen-producing tumor. such extreme virilization is very rarely observed in PCO or in Cushing syndrome; more over the presence of normal cortisol and adrenal androgen DHEAS plus a markedly elevated plasma testosterone levels indicates an ovarian rather than adrenal cause of the findings.
Arrhenoblastomas are the most common androgen producing ovarian tumors their incidence is highest during reproductive years. composed of varying proportions of leydig and sertoli cells. they are generally benign.
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Old 11-04-2011
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arrhenoblastoma
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