Ovarian steroid cell tumor as an example of severe hyperandrogenism in 45-year-old woman

• Published in: Gynecological endocrinology Vol. 36; no. 4; pp. 303 - 307
• Main Authors: Szeliga, Anna, Zysnarska, Aleksandra, Podfigurna, Agnieszka, Maciejewska-Jeske, Marzena, Moszyński, Rafał, Sajdak, Stefan, Jasiński, Piotr, Frankowski, Andrzej, Genazzani, Andrea R, Męczekalski, Błażej
• Format: Journal Article
• Language: English
• Published: England 02.04.2020
• Subjects: Female; Humans; Hyperandrogenism - diagnosis; Hyperandrogenism - etiology; Hyperandrogenism - pathology; Hyperandrogenism - surgery; Middle Aged; Ovarian Neoplasms - complications; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - surgery; Severity of Illness Index; Sex Cord-Gonadal Stromal Tumors - complications; Sex Cord-Gonadal Stromal Tumors - diagnosis; Sex Cord-Gonadal Stromal Tumors - surgery; Steroid cell tumor; hirsutism; hyperandrogenism; ovarian tumor
• ISSN: 0951-3590; 1473-0766
• DOI: 10.1080/09513590.2019.1689551

Approximately, 5% of ovarian tumors have hormonal activity. Steroid cell tumors (SCTs) represent about 0.1% of all ovarian tumors. They cause hyperandrogenism associated with typical virilization. In this case report, we present 45-year-old women with unmalignant ovarian SCT-producing androgens which cause severe virilization and secondary amenorrhea lasting two years. Transvaginal ultrasound, computed tomography of adrenal glands, magnetic resonance imaging of small pelvis, laboratory tests (including serum concentration of FSH, LH, testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEA-S), as well as ROMA index) were performed. During hormonal evaluation, elevated concentrations of serum T - on admission 1.72 ng/ml and one month later 3.75 ng/ml (normal range 0.08-0.82 ng/ml) and A - 24.90 ng/ml (normal range 0.40-3.40 ng/ml) were found. The ROMA index was within the normal range. Enlargement of the left ovary by solid mass 56 × 43 mm was found during ultrasound examination. Based on small pelvis MRI scan and hormonal finding, patient was qualified for laparotomy. During this procedure, the left salpingo-oophorectomy with removal of the tumor was performed. The histopathological examination identified SCT. During follow-up examination, one day after surgery, we found serum testosterone levels within normal ranges - 0.74 ng/ml (normal range 0.08-0.82 ng/ml). This case shows that hormone-producing ovarian tumors are rare but very important clinical causes of severe hyperandrogenism.