OVARIAN PATHOLOGY ASSOCIATED WITH INSULIN RESISTANCE AND ACANTHOSIS NIGRICANS

Abstract

Insulin resistance and the skin lesions of acanthosis nigricans are not commonly seen by the gynecologist, but the ovarian pathology that can be associated with insulin resistance and acanthosis nigricans is well known. The clinical course of disease in a patient with virilization-amenorrhea associated with insulin resistance and acanthosis nigricans is presented to illustrate the association. Hyperthecosis was the ovarian pathology demonstrated; testosterone levels were > 400 ng/dl. Postoperative testosterone levels were normal at 42 ng/dl. Additional ovarian pathology reported in association with insulin resistance and acanthosis nigricans includes polycystic ovary disease alone, in association with stromal luteomas or with bilateral dermoid cysts. Masculinizing ovarian neoplasms such as hilar cell tumors were reported in association with ovarian hyperthecosis. In the evaluation of patients with androgen excess the association with abnormal carbohydrate metabolism and acanthosis nigricans should be considered.