Symptomatic ovarian steroid cell tumor not otherwise specified in a post-menopausal woman

Symptomatic ovarian steroid cell tumor not otherwise specified in a post-menopausal woman

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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 ted lasso energy drink 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 hamamelis crema diagnostic and therapeutic bilateral salpingooophorectomy 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.