Value of selective venous catheterization in the diagnosis of hyperandrogenism

Fertility and Sterility
Lisa C HickmanTommaso Falcone

Abstract

To discuss the clinical utility of ovarian vessel sampling in the context of the evaluation and treatment of ovarian hyperthecosis. Patient presentation in video format, ovarian vessel sampling demonstration, surgical technique explanation, surgical histology discussion and ovarian hyperthecosis review. Academic medical center. A 30-year-old nulligravid female presented with severe hyperandrogenic features, consistent with polycystic ovary syndrome. During the course of her diagnostic evaluation, she underwent selective ovarian and adrenal vein sampling. Assessment of ovarian vessel testosterone levels and review of final histologic findings. Selective ovarian and adrenal vein sampling revealed right ovarian testosterone levels that were 200 times the upper limit of normal. As occult malignancy was a concern, laparoscopy was performed, with nearly complete removal of the right ovarian stroma. Pathology revealed ovarian stromal hyperthecosis without evidence of malignancy. Selective venous sampling is a technically challenging procedure, which may help localize an occult malignancy in limited circumstances. In utilizing selective venous sampling, one must consider the limitations of the test, potential for false positive results...Continue Reading

References

Jan 1, 1986·Cardiovascular and Interventional Radiology·R SörensenU Schwartz
Sep 28, 1995·The New England Journal of Medicine·S Franks
Jan 9, 2004·Fertility and Sterility·UNKNOWN Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group
Jun 5, 2007·Cardiovascular and Interventional Radiology·Jeshen H G LauMatthew Matson
Apr 9, 2008·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·R RajputR Singh

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Citations

Feb 2, 2021·Endocrinology and Metabolism Clinics of North America·Margaret E Wierman

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