RESUMO
A case of ovarian Brenner tumor displaying androgenic activity and clinical masculinization is reported in a 65-year-old woman. Plasma androstenedione, dehydroepiandrosterone sulfate (DHEAS), testosterone, dihydrotestosterone, cortisol, estradiol, FSH, LH, and prolactin were measured before and after suppression with dexamethasone and stimulation with hCG, and again after removal of the tumor. The plasma androgenic compounds were measured in both ovarian and peripheral veins. Basal levels of androstenedione and of total testosterone were significantly elevated, decreasing to normal ranges after operation and remaining after 3 months. There was a sharp increase of total testosterone, DHEAS, and dihydrotestosterone levels after administration of hCG. The levels of androstenedione, DHEAS, testosterone, and dihydrotestosterone were higher in the ovarian vein than in the peripheral vein. These findings indicate that the tumor was the main source of these androgenic hormones.
Assuntos
Tumor de Brenner/complicações , Hirsutismo/etiologia , Neoplasias Ovarianas/complicações , Idoso , Tumor de Brenner/sangue , Tumor de Brenner/patologia , Tumor de Brenner/cirurgia , Feminino , Humanos , Menopausa/sangue , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Ovário/irrigação sanguínea , Hormônios Hipofisários/sangue , VeiasRESUMO
A simple operation, anterior abdominal wall colpopexy using autogenous strips of rectus fascia, to repair posthysterectomy prolapse of the vaginal vault, is described. It is mainly indicated for patients with complete vaginal eversion, in whom preservation of a physiologically useful vagina is highly desirable. Normal vaginal caliber and depth were secured and no recurrence has arisen in a series of nine patients operated upon for complete prolapse of the vaginal vault after hysterectomy, seven of whom have been followed up for six months to 12 years.