Résumé

P369

Database analysis of women with tumor-level serum testosterone

Dr P. KAZAKOUa, Dr P. SAXa, Dr C. GERVYa, Pr B. CORVILAINa, Pr N. DRIESSENSa

a Hôpital Erasme, Faculty of Medicine, Université Libre de Bruxelles, Belgium, Bruxelles

 

In case of female hyperandrogenism, total testosterone assay is recommended as first-line test as it is, among androgens, the best predictor of tumour. A total testosterone above twice the upper normal value by direct assays requires exclusion of androgen producing tumour (virilizing ovarian/adrenal tumour).

The aim of this work was to evaluate the number, the final diagnosis and the quality of care of women with an elevation of total testosterone ≥1.6ng/ml measured by direct RIA assay (normal range:0.2-0.8ng/ml). From the lab database (between 2004 and 2013), 130 women were identified. Testosterone measurement was asked by endocrinologists (25%), gynaecologists (50%) and others (25%).

In ascending order of total testosterone values, associated diagnosis were: hyperprolactinemia, unknown, PCOS, Cushing’s disease, pregnancy, congenital adrenal hyperplasia, androgen therapies in post-menopausal women, men misclassified as women by data processing, transgender patients, adrenocortical tumour and androgen insensitivity syndrome. In our database, there was no virilizing ovarian tumour and only one case of adrenocortical tumour. The maximal total testosterone value was 3ng/ml in PCOS group and 7ng/ml in the adrenocortical tumour case. PCOS group concerns more than 30% of patients and corresponds probably to severe form of PCOS. In patients without diagnosis (~20%), ovarian ultrasonography was performed in 50% of patients while adrenal imaging in only 15%.

In conclusion, analyzing a hospital lab database is a way to create a registry of uncommon diseases. It permits also to assess and improve the quality of care in patients with rare disease or with lab values that require further assessment.

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