POSTMENOPAUSAL OVARIAN HYPERANDROGENISM: A CASE REPORT AND SCOPING REVIEW WITH INDIVIDUAL PATIENT'S DATA ANALYSIS OF PATIENTS SURGICALLY TREATED

Angelo Forte¹Lanfranco D'Elia¹De Luca Carmine¹Antonella Fiore¹Antonio Barbato¹Veronica Abate¹Anita Vergatti¹Nunzia Verde¹Gianpaolo De Filippo²Pietro Venetucci³Maria Chiara De Angelis⁴Rosa Maria Di Crescenzo³Francesco Grasso³Giuseppe Perruolo⁵Pietro Formisano⁵Attilio Di Spiezio Sardo⁶Rosario Pivonello^1*Domenico Rendina^1*

• ¹Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
• ²Hôpital Robert Debré, Paris, France
• ³Department of Advanced Biomedical Sciences, School of Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
• ⁴Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
• ⁵Department of Translational Medical Sciences, School of Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
• ⁶Department of Public Health, School of Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy

Introduction. Postmenopausal hyperandrogenism (PH) is a rare clinical condition caused by relative or absolute androgen excess after menopause. Tumorous or non-tumorous ovarian diseases can cause PH.Methods. In this two-section hybrid study, the first section describes the case of a patient with PH caused by an ovarian disease and surgically treated. The second section shows the results of a scoping review with individual patients' data analysis (IPD), performed to define biochemical and clinical features of PH patients with tumorous or non-tumorous ovarian diseases surgically treated. All PH caused by anything but ovarian disease and/or without surgical indication and/or without histological diagnosis were excluded.Results. Because of imaging suspicion, our PH patient underwent robotic hysterectomy with bilateral ovariectomy. A Leydig cell tumor stage 1A was diagnosed. Six months after surgery, PH was resolved. Overall, the IPD analysis collected 280 PH patients with ovarian diseases surgically treated (oPH). Among them, histological examination showed 174 tumorous-oPH and 106 non-tumorous-oPH. Tumorous-oPH patients showed lower body mass index and lower levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) as well as higher levels of testosterone, dehydroepiandrosterone-sulphate (DHEA-S), 17-OH progesterone and estradiol compared to nontumorous-oPH patients. We define levels of testosterone (≥9.8 nmol/L), LH (≤15 mUI/ml), FSH (≤35 mUI/ml), and DHEAS (≥1.6 mol/L) able to differentiate tumorous-and non-tumorous-oPH patients with proper sensitivity (≥68.6%) and specificity (≥72.7%). No PH recurrence was described after surgery.Discussion. The study results provide useful biochemical parameters to support the diagnosis of ovarian tumour in oPH patients.