Selective ovarian vein sampling to localize a Leydig cell tumor.
OBJECTIVE
To describe a patient with recent onset of rapidly progressive virilization who was diagnosed with an androgen-secreting tumor of the left ovary, localized by selective ovarian vein catheterization and hormonal sampling (SOVHS).


METHODS
Case report.


METHODS
Tertiary community-based medical center.


METHODS
A 32-year-old woman presenting with progressive virilization over a period of 4 months was found to have a Leydig cell tumor of the left ovary.


METHODS
Transvaginal ultrasound of the pelvis, followed by contrast-enhanced computerized tomography of the abdomen and the pelvis. Selective ovarian vein sampling was performed to localize the tumor. Laparoscopic left salpingo-oophorectomy and washings were also performed.


METHODS
Initial serum total T levels were 1,505 ng/dL, and the free serum T levels were 234 ng/dL. After SOVHS, the total serum T levels in the left ovarian vein is reported to be 20,967 ng/dL, and in the right ovarian vein, they were reported to be 1,351 ng/dL. Three months after laparoscopic left oophorectomy, the serum total T levels were 11 ng/dL. Institutional review board approval was obtained.


RESULTS
Patient's ovarian tumor removed laparoscopically was reported to be a Leydig cell tumor. Rapid decreases in free and total T followed tumor removal.


CONCLUSIONS
Selective ovarian vein catheterization and hormonal sampling is an effective diagnostic modality that can help localize small ovarian tumors.
Dickerson
Ryan D
RD
Department of Obstetrics and Gynecology, Dallas, Texas, USA.
Putman
Michael J
MJ
Black
Michael E
ME
Pinto
Karen R
KR
Diamond
Norman G
NG
Marynick
Samuel
S
Pinto
Anil B
AB
D000328:Adult; D005260:Female; D006801:Humans; D007984:Leydig Cell Tumor / Q000097:blood / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis*; D010053:Ovary / Q000098:blood supply*; D014680:Veins