Use of F 18-fluoro-D-glucose-positron emission tomography-computed tomography to localize a hilar cell tumor of the ovary.
OBJECTIVE
To describe provocative testing and alternative imaging strategies used to localize an androgen-producing tumor in a 58-year-old woman with severe hirsutism.


METHODS
Case report.


METHODS
Clinical Research Center.


METHODS
A 58-year-old woman who was seen for evaluation of severe hirsutism.


METHODS
Serum androgen levels were measured at baseline, 4 hours after administration of 2000 IU of hCG, and 11 days after administration of 3.75 mg of leuprolide acetate (LA). Magnetic resonance imaging and F 18-fluoro-D-glucose-positron emission tomography-computed tomography (FDG-PET/CT) were performed.


METHODS
Description of preoperative provocative testing and imaging.


RESULTS
In response to hCG, T rose from 243 to 288 ng/dL then decreased to 233 ng/dL after LA administration. The FDG-PET/CT scan demonstrated focal hypermetabolism in the right pelvis, corresponding to a soft-tissue density on the noncontrast CT scan. Magnetic resonance images were correlated with the PET/CT, and the right ovary was identified. Right salpingo-oophorectomy was performed, and final pathologic examination revealed a hilar cell tumor with ovarian cortical hyperplasia.


CONCLUSIONS
This case demonstrates the utility of provocative testing in the evaluation of a patient with severe hirsutism and illustrates the value of FDG-PET/CT when traditional imaging is nondiagnostic.
McCarthy-Keith
Desireé M
DM
Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892-1109, USA.
Hill
Micah
M
Norian
John M
JM
Millo
Corina
C
McKeeby
Jeffrey
J
Armstrong
Alicia Y
AY
D000728:Androgens / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D006628:Hirsutism / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D018309:Neoplasms, Gonadal Tissue / Q000000981:diagnostic imaging* / Q000556:secondary; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
D000728:Androgens; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18