A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome

Background. Polycystic ovary syndrome (PCOS) is a common endocrine disorder with heterogeneous etiology. Typical features consist of oligo/anovulation, polycystic ovaries, and features of hyperandrogenism. Pathogenesis is multifactorial, and positive family history may have a predisposition for dise...

Full description

Bibliographic Details
Main Authors: S. Pathmanathan, I. Ranathunga, N. P. Somasundaram
Format: Article
Language:English
Published: Hindawi Limited 2020-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2020/8893000
id doaj-3ae4dd1c230f4b0db0adab11fbbd4c0b
record_format Article
spelling doaj-3ae4dd1c230f4b0db0adab11fbbd4c0b2020-12-07T09:08:26ZengHindawi LimitedCase Reports in Endocrinology2090-65012090-651X2020-01-01202010.1155/2020/88930008893000A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary SyndromeS. Pathmanathan0I. Ranathunga1N. P. Somasundaram2Diabetes and Endocrinology Unit, District General Hospital-Kaluthara, Kaluthara, Sri LankaDiabetes and Endocrinology Unit, National Hospital of Sri Lanka, Colombo, Sri LankaDiabetes and Endocrinology Unit, National Hospital of Sri Lanka, Colombo, Sri LankaBackground. Polycystic ovary syndrome (PCOS) is a common endocrine disorder with heterogeneous etiology. Typical features consist of oligo/anovulation, polycystic ovaries, and features of hyperandrogenism. Pathogenesis is multifactorial, and positive family history may have a predisposition for disease development. The syndrome is associated with multiple metabolic and nonmetabolic entities. As the disease is involved with multiple adverse outcomes, the successful treatment is pivotal. Among the more advanced options, the unilateral oophorectomy is considered as a last resort to alleviate the symptoms. Case Presentation. A 29-year-old female presented to us with oligomenorrhea, severe hirsutism, androgenic pattern hair loss, acne, increased skin pigmentation, and secondary subfertility. On examination, she was obese with a body mass index (BMI) of 29.6 kg/m2. She had evidence of acanthosis nigricans, androgenic pattern balding, acne, dorsal, supraclavicular fat deposition, and moderate-severe hirsutism. Investigations confirmed excess right ovarian testosterone secretion which led to the ultimate management with right oophorectomy with successful alleviation of clinical features. Conclusions. The multifaceted medical treatment comprises the first-line therapy in PCOS. Surgery is considered as a second-line option in resistant PCOS following failure of initial therapeutic options. We report a case of resistant polycystic ovary syndrome with secondary subfertility and moderate-to-severe hirsutism who was successfully treated with unilateral oophorectomy with favorable results.http://dx.doi.org/10.1155/2020/8893000
collection DOAJ
language English
format Article
sources DOAJ
author S. Pathmanathan
I. Ranathunga
N. P. Somasundaram
spellingShingle S. Pathmanathan
I. Ranathunga
N. P. Somasundaram
A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome
Case Reports in Endocrinology
author_facet S. Pathmanathan
I. Ranathunga
N. P. Somasundaram
author_sort S. Pathmanathan
title A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome
title_short A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome
title_full A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome
title_fullStr A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome
title_full_unstemmed A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome
title_sort case of successful treatment with unilateral oophorectomy in a patient with resistant polycystic ovary syndrome
publisher Hindawi Limited
series Case Reports in Endocrinology
issn 2090-6501
2090-651X
publishDate 2020-01-01
description Background. Polycystic ovary syndrome (PCOS) is a common endocrine disorder with heterogeneous etiology. Typical features consist of oligo/anovulation, polycystic ovaries, and features of hyperandrogenism. Pathogenesis is multifactorial, and positive family history may have a predisposition for disease development. The syndrome is associated with multiple metabolic and nonmetabolic entities. As the disease is involved with multiple adverse outcomes, the successful treatment is pivotal. Among the more advanced options, the unilateral oophorectomy is considered as a last resort to alleviate the symptoms. Case Presentation. A 29-year-old female presented to us with oligomenorrhea, severe hirsutism, androgenic pattern hair loss, acne, increased skin pigmentation, and secondary subfertility. On examination, she was obese with a body mass index (BMI) of 29.6 kg/m2. She had evidence of acanthosis nigricans, androgenic pattern balding, acne, dorsal, supraclavicular fat deposition, and moderate-severe hirsutism. Investigations confirmed excess right ovarian testosterone secretion which led to the ultimate management with right oophorectomy with successful alleviation of clinical features. Conclusions. The multifaceted medical treatment comprises the first-line therapy in PCOS. Surgery is considered as a second-line option in resistant PCOS following failure of initial therapeutic options. We report a case of resistant polycystic ovary syndrome with secondary subfertility and moderate-to-severe hirsutism who was successfully treated with unilateral oophorectomy with favorable results.
url http://dx.doi.org/10.1155/2020/8893000
work_keys_str_mv AT spathmanathan acaseofsuccessfultreatmentwithunilateraloophorectomyinapatientwithresistantpolycysticovarysyndrome
AT iranathunga acaseofsuccessfultreatmentwithunilateraloophorectomyinapatientwithresistantpolycysticovarysyndrome
AT npsomasundaram acaseofsuccessfultreatmentwithunilateraloophorectomyinapatientwithresistantpolycysticovarysyndrome
AT spathmanathan caseofsuccessfultreatmentwithunilateraloophorectomyinapatientwithresistantpolycysticovarysyndrome
AT iranathunga caseofsuccessfultreatmentwithunilateraloophorectomyinapatientwithresistantpolycysticovarysyndrome
AT npsomasundaram caseofsuccessfultreatmentwithunilateraloophorectomyinapatientwithresistantpolycysticovarysyndrome
_version_ 1715013342254333952