{Reference Type}: Case Reports
{Title}: Ovarian hyperthecosis in adolescent females: two case reports and a review of the literature.
{Author}: Angley E;Vollenhoven B;White M;
{Journal}: J Pediatr Endocrinol Metab
{Volume}: 37
{Issue}: 9
{Year}: 2024 Sep 25
{Factor}: 1.52
{DOI}: 10.1515/jpem-2024-0223
{Abstract}: <B>OBJECTIVE: </B>Ovarian hyperthecosis (OHT) is a rare cause of severe hyperandrogenism in the adolescent age group. We describe two case reports, and present an approach to management in this age group based on a review of the literature.<BR><B>METHODS: </B>Patient A presented at age 13 years with a 2 year history of androphonia and hirsuitism. Her testosterone level was elevated at 8.3 nmol/L, and there was marked enlargement of her ovaries bilaterally. There were no focal adrenal or ovarian lesions identified on imaging. She was treated with a gonadotropin releasing hormone (GnRH) agonist and spironolactone with biochemical and clinical improvement. Patient B presented at age 14 years with secondary amenorrhoea, and a 2 year history of androphonia, hirsutism and androgenetic alopecia. Her testosterone level was 12 nmol/L, and a pelvic ultrasound revealed numerous follicles in each ovary which were otherwise normal in size. She was managed with GnRH agonist initially, and now continues on a combined oral contraceptive pill.<BR><B>CONCLUSIONS: </B>Ovarian hyperthecosis needs to be considered in pre-menopausal women presenting with severe hyperandrogenism, after exclusion of androgen-producing adrenal and ovarian tumours. The principles of management in this age group are gonadotropin suppression and hormone replacement.