June 6th, 2020

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Testosterone-Producing Ovarian Tumor: A Case Report
Authors:  Nishita Patel, M.D., John Hoff, M.D., and M. Brigid Holloran-Schwartz, M.D.
BACKGROUND: Ovarian androgen-producing tumors are very rare. Of all androgen excess disorders, they make up only 0.2%. Steroid cell tumors, not otherwise specified, are a specific type of androgen-secreting tumors with malignant potential. This report will delve into the diagnosis of this tumor and the importance of prompt diagnosis.

CASE: A 24-year-old, obese female with no other significant past medical history presented for an annual gynecologic examination with concern of a 3-year history of amenorrhea. Physical examination revealed male pattern hair growth and acanthosis nigricans with a working diagnosis of polycystic ovary syndrome. Her TSH, FSH, LH, and prolactin were normal, but transvaginal ultrasound revealed a 3.8 cm right ovarian mass. She was referred to a gynecologist, who ordered additional labs and a CT scan notable for elevated testosterone. She was referred to a minimally invasive gynecologic surgeon with the working diagnosis of a testosterone-secreting tumor. The patient underwent a right salpingo-oophorectomy which confirmed a benign ovarian steroid cell tumor. On follow-up the patient reported return of her menses.

CONCLUSION: This case teaches the importance of always considering the rare diagnoses. It highlights the importance of testing for testosterone in women who present with hirsutism and amenorrhea.
Keywords:  amenorrhea, hirsutism, hyperandrogenism, infertility, ovarian tumor, polycystic ovary syndrome, testosterone
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