title: Use of F 18-fluoro-D-glucose-positron emission tomography-computed tomography to localize a hilar cell tumor of the ovary.
abstract: 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.
authors.affiliation: 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.
authors.forename: Desireé M
authors.initials: DM
authors.lastname: McCarthy-Keith
authors.forename: Micah
authors.initials: M
authors.lastname: Hill
authors.forename: John M
authors.initials: JM
authors.lastname: Norian
authors.forename: Corina
authors.initials: C
authors.lastname: Millo
authors.forename: Jeffrey
authors.initials: J
authors.lastname: McKeeby
authors.forename: Alicia Y
authors.initials: AY
authors.lastname: Armstrong
mesh_terms: 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
chemical_list: D000728:Androgens; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18