title: Symptomatic Ovarian Steroid Cell Tumor not Otherwise Specified in a Post-Menopausal Woman.
abstract: Steroid cell tumor not otherwise specified (NOS) is a rare subtype of sex cord stromal tumor of the ovary and contributes less than 0.1% of all ovarian neoplasms. The majority of tumors occur in pre-menopausal women (mean age: 43 years), in which 56-77% of patients present with virilization due to excess testosterone. An 80-year-old woman with worsening alopecia and excessive growth of coarse hair on abdomen and genital area was found to have elevated serum testosterone level (462 ng/mL). Radiologic studies were consistent with bilateral adrenal adenomas. Bilateral adrenal venous sampling ruled out the adrenal gland as origin of hormone secretion. A diagnostic and therapeutic bilateral salpingo-oophorectomy confirmed steroid cell tumor NOS of the left ovary. Post-operatively, the patient had complete resolution of her symptoms and normalization of testosterone level. Our case emphasizes the importance of a clinical suspicion for an occult testosterone secreting ovarian tumor in a symptomatic patient without obvious ovarian mass on imaging.
authors.affiliation: Department of Medical and Surgical Gynecology.
authors.forename: Neha
authors.initials: N
authors.lastname: Sood
authors.affiliation: Division of Endocrinology.
authors.forename: Kaniksha
authors.initials: K
authors.lastname: Desai
authors.affiliation: Division of Endocrinology.
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Chindris
authors.affiliation: Department of Pathology, Mayo Clinic , Jacksonville, FL, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Lewis
authors.affiliation: Department of Medical and Surgical Gynecology.
authors.forename: Tri A
authors.initials: TA
authors.lastname: Dinh
keywords: Steroid cell tumor not otherwise specified (NOS); adrenal venous sampling; virilization